Provider Demographics
NPI:1366634453
Name:TSITSINIAN, GARBIS (DC)
Entity Type:Individual
Prefix:DR
First Name:GARBIS
Middle Name:
Last Name:TSITSINIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 S CENTRAL AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-4343
Mailing Address - Country:US
Mailing Address - Phone:818-240-2626
Mailing Address - Fax:818-240-1252
Practice Address - Street 1:730 S CENTRAL AVE STE 202
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-4343
Practice Address - Country:US
Practice Address - Phone:818-240-2626
Practice Address - Fax:818-240-1252
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18984111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC18984Medicare PIN
CAB50866Medicare UPIN