Provider Demographics
NPI:1326561622
Name:ARMEN MANSSOURIAN
Entity Type:Organization
Organization Name:ARMEN MANSSOURIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:SAVERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-242-2667
Mailing Address - Street 1:1122 N BRAND BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-2570
Mailing Address - Country:US
Mailing Address - Phone:818-242-2667
Mailing Address - Fax:818-242-2667
Practice Address - Street 1:1122 N BRAND BLVD STE 102
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-2570
Practice Address - Country:US
Practice Address - Phone:818-242-2667
Practice Address - Fax:818-242-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental