Petit Ave Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

PETIT AVE INC.

Practice address

6719 Quakertown Ave
Winnetka, CA 91306-4336

Phone

(818) 945-4374

Fax

(818) 435-3079

NPI assigned

Jun 7, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Edgar Ghazaryan, RRT, RCP

Title

Ceo

Phone

(818) 945-4374

Specialties & licenses 1

Addresses

Other names 1

• AURORA CARE Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561420800000",
    "number": "1669965349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6719 QUAKERTOWN AVE",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913064336",
            "telephone_number": "818-945-4374",
            "fax_number": "818-435-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6719 QUAKERTOWN AVE",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913064336",
            "telephone_number": "818-945-4374",
            "fax_number": "818-435-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETIT AVE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2019-06-25",
        "status": "A",
        "authorized_official_last_name": "GHAZARYAN",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-945-4374",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT, RCP"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AURORA CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AURORA CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Winnetka, CA
• Providers in Winnetka, CA by specialty
• Nursing Facility/Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.