Provider Demographics
NPI:1043589211
Name:TOVMASSIAN, GREGORY ARKADIEVICH (DPM)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ARKADIEVICH
Last Name:TOVMASSIAN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:5120 MANZANITA AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0590
Mailing Address - Country:US
Mailing Address - Phone:916-459-4398
Mailing Address - Fax:916-965-6715
Practice Address - Street 1:6600 MERCY CT STE 150
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628
Practice Address - Country:US
Practice Address - Phone:916-459-4398
Practice Address - Fax:916-965-6715
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-17
Last Update Date:2018-08-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAE4971213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery