Provider Demographics
NPI:1538605357
Name:HOLLYWOOD MEDICAL REHABILITAION CARE, INC
Entity type:Organization
Organization Name:HOLLYWOOD MEDICAL REHABILITAION CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVMASYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-268-7197
Mailing Address - Street 1:5232 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5710
Mailing Address - Country:US
Mailing Address - Phone:323-660-0900
Mailing Address - Fax:323-660-0908
Practice Address - Street 1:5232 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-5710
Practice Address - Country:US
Practice Address - Phone:323-660-0900
Practice Address - Fax:323-660-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder