Blue Lotus Healthcare Holding Corp

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

BLUE LOTUS HEALTHCARE HOLDING CORP

Practice address

20944 Sherman Way Ste 112
Canoga Park, CA 91303-3629

Phone

(310) 467-0661

NPI assigned

Mar 15, 2022

Organization subpart

No

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

Authorized official

Name

Mandana Amin Nazar

Title

Ceo

Phone

(310) 467-0661

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1376291674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3712 PASEO PRIMARIO",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913023054",
            "telephone_number": "310-467-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20944 SHERMAN WAY STE 112",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033629",
            "telephone_number": "310-467-0661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LOTUS HEALTHCARE HOLDING CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-15",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "AMIN NAZAR",
        "authorized_official_first_name": "MANDANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-467-0661"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.