Provider Demographics
NPI:1174823363
Name:VAHE BADALIAN MD INC
Entity Type:Organization
Organization Name:VAHE BADALIAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VAHE
Authorized Official - Middle Name:
Authorized Official - Last Name:BADALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-247-9200
Mailing Address - Street 1:1530 E CHEVY CHASE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4139
Mailing Address - Country:US
Mailing Address - Phone:818-247-9200
Mailing Address - Fax:818-484-8190
Practice Address - Street 1:1530 E CHEVY CHASE DR STE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4139
Practice Address - Country:US
Practice Address - Phone:818-247-9200
Practice Address - Fax:818-484-8190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-22
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A452220Medicaid
CA00A452220Medicaid