Provider Demographics
NPI:1043474513
Name:AMIRKHANIAN NAMAGERDY, SEBO (MD)
Entity Type:Individual
Prefix:
First Name:SEBO
Middle Name:
Last Name:AMIRKHANIAN NAMAGERDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9662 CABANAS AVE
Mailing Address - Street 2:
Mailing Address - City:TUJUNGA
Mailing Address - State:CA
Mailing Address - Zip Code:91042-2923
Mailing Address - Country:US
Mailing Address - Phone:310-903-0188
Mailing Address - Fax:
Practice Address - Street 1:9662 CABANAS AVE
Practice Address - Street 2:
Practice Address - City:TUJUNGA
Practice Address - State:CA
Practice Address - Zip Code:91042-2923
Practice Address - Country:US
Practice Address - Phone:310-903-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital