Seaside Homehealth,Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SEASIDE HOMEHEALTH,INC

Practice address

7301 Topanga Canyon Blvd Ste 303
Canoga Park, CA 91303-3395

Phone

(747) 888-4844

Fax

(747) 777-8688

NPI assigned

Jun 26, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Roman Khachaturov

Title

Ceo

Phone

(747) 888-4844

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 559450

Legal name

SEASIDE HOMEHEALTH,INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 12, 2021

Last certification

Feb 12, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Apr 24, 2019 in CA

Enrollment address

7301 Topanga Canyon Blvd
Ste 303
Canoga Park, CA 91303-3395

Listed as

Seaside Home HealthCCN 559450 · All quality measures

Overall star rating

4 of 5

Ownership

Proprietary

Certified

Feb 12, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1275194540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 TOPANGA CANYON BLVD STE 303",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033394",
            "telephone_number": "747-888-4844",
            "fax_number": "747-777-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 TOPANGA CANYON BLVD STE 303",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033395",
            "telephone_number": "747-888-4844",
            "fax_number": "747-777-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE HOMEHEALTH,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-26",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "KHACHATUROV",
        "authorized_official_first_name": "ROMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-888-4844",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.