Penta Star Inc

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

PENTA STAR INC

Practice address

204 E Chevy Chase Dr # 5
Glendale, CA 91205-3178

Phone

(818) 550-8150

Fax

(818) 550-8160

NPI assigned

May 16, 2007

Organization subpart

No

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

Authorized official

Name

Andranik Tatevosian

Title

Chief Financial Officer

Phone

(818) 550-8150

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eagle Wings Medical Transportation Doing business as

Locations

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243468800000",
    "number": "1508072307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 E CHEVY CHASE DR # 5",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053178",
            "telephone_number": "818-550-8150",
            "fax_number": "818-550-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E CHEVY CHASE DR # 5",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053178",
            "telephone_number": "818-550-8150",
            "fax_number": "818-550-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENTA STAR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2009-05-28",
        "status": "A",
        "authorized_official_last_name": "TATEVOSIAN",
        "authorized_official_first_name": "ANDRANIK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "818-550-8150"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "MTN01231F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Wings Medical Transportation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Salma Pena
• Penciu Medical Apmc
• Cristian Penciu, M.D.
• Debbie Hwa-Yun Peng, MD
• Paul Logronio Penoliar, OTR/L C/NDT
• Megan Courtney Pepper, FNP
• Mirihana Arachchige Senani ('Senani Mariya Perera-Garrity
• Perez Dental Corp
• Xochitl Marlenne Perez Gaytan Jr.
• Diana Karen Perez Higareda

• Non-emergency Medical Transport (VAN) in Glendale, CA
• Providers in Glendale, CA by specialty
• Non-emergency Medical Transport (VAN) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2009; 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.