Provider Demographics
NPI:1508042631
Name:DIKRANIAN UROLOGY INC
Entity Type:Organization
Organization Name:DIKRANIAN UROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIKRANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-281-3701
Mailing Address - Street 1:901 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-4442
Mailing Address - Country:US
Mailing Address - Phone:626-281-3701
Mailing Address - Fax:
Practice Address - Street 1:901 S GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-4442
Practice Address - Country:US
Practice Address - Phone:626-281-3701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA752312088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Single Specialty