Provider Demographics
NPI:1053158303
Name:LYNGLEN HEALTH SERVICES
Entity type:Organization
Organization Name:LYNGLEN HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOGOMONYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-240-4376
Mailing Address - Street 1:2600 FOOTHILL BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-4579
Mailing Address - Country:US
Mailing Address - Phone:747-240-4376
Mailing Address - Fax:
Practice Address - Street 1:2600 FOOTHILL BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-4579
Practice Address - Country:US
Practice Address - Phone:747-240-4376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies