Provider Demographics
NPI:1144465857
Name:HEAD CROWN & WEALTH INCORPORATED
Entity type:Organization
Organization Name:HEAD CROWN & WEALTH INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OJOBARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-883-6100
Mailing Address - Street 1:22156 SHERMAN WAY
Mailing Address - Street 2:UNIT C1
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1143
Mailing Address - Country:US
Mailing Address - Phone:818-883-6100
Mailing Address - Fax:818-883-6010
Practice Address - Street 1:22156 SHERMAN WAY
Practice Address - Street 2:UNIT C1
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1143
Practice Address - Country:US
Practice Address - Phone:818-883-6100
Practice Address - Fax:818-883-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6297950001Medicare NSC