Provider Demographics
NPI:1417470261
Name:MILLENNIUM UROLOGY INC
Entity Type:Organization
Organization Name:MILLENNIUM UROLOGY INC
Other - Org Name:CHN
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:PETROSSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-283-4876
Mailing Address - Street 1:6226 E SPRING ST STE 260
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1454
Mailing Address - Country:US
Mailing Address - Phone:818-445-3432
Mailing Address - Fax:562-731-2926
Practice Address - Street 1:6226 E SPRING ST STE 260
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1454
Practice Address - Country:US
Practice Address - Phone:818-445-3432
Practice Address - Fax:562-731-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty