Provider Demographics
NPI:1417974478
Name:BALIAN, HAROUT RAFFI (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROUT
Middle Name:RAFFI
Last Name:BALIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 N HILL AVE
Mailing Address - Street 2:STE. 101
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1570
Mailing Address - Country:US
Mailing Address - Phone:626-449-9911
Mailing Address - Fax:626-449-9921
Practice Address - Street 1:333 N HILL AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1570
Practice Address - Country:US
Practice Address - Phone:626-449-9911
Practice Address - Fax:626-449-9921
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA494292081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A494291Medicaid
CA00A494293Medicaid
CA00A494291Medicaid
F56434Medicare UPIN