Provider Demographics
NPI:1417496332
Name:ARMEN NERCESSIAN DO INC
Entity Type:Organization
Organization Name:ARMEN NERCESSIAN DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:YEGHIA
Authorized Official - Last Name:NERCESSIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-345-9022
Mailing Address - Street 1:1710 E WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-2751
Mailing Address - Country:US
Mailing Address - Phone:626-345-9022
Mailing Address - Fax:626-345-9019
Practice Address - Street 1:1710 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-2751
Practice Address - Country:US
Practice Address - Phone:626-345-9022
Practice Address - Fax:626-345-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6784208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty