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Organization

SHOUSHAN GUKASYAN

Active
Other names
A HOMECARE DEVICE CO.
Organization subpart
No

Provider details

NPI number
Authorized official
VARTAN GUKASYAN HMDR EXEMPTEE (GENERAL MANAGER)
(818) 767-7003
Entity
Organization

Contact information

Practice address
8217 LANKERSHIM BLVD STE 29, NORTH HOLLYWOOD, CA 91605-0937
(818) 767-7003
(818) 767-1781
Mailing address
905 GRAYNOLD AVE, GLENDALE, CA 91202-2638
(818) 956-8234
(818) 767-1781

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
102722
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
16831
CA
335E00000X
Prosthetic/Orthotic Supplier
Primary
R16755
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DME03085F
CA
Enumeration date
10/04/2006
Last updated
09/11/2025
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