Provider Demographics
NPI:1508062738
Name:GARBIS KASSABIAN, M.D., INC. A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:GARBIS KASSABIAN, M.D., INC. A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARBIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KASSABIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-837-6830
Mailing Address - Street 1:14901 RINALDI ST
Mailing Address - Street 2:SUITE # 305
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1204
Mailing Address - Country:US
Mailing Address - Phone:818-837-6830
Mailing Address - Fax:818-837-6832
Practice Address - Street 1:14901 RINALDI ST
Practice Address - Street 2:SUITE # 305
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1204
Practice Address - Country:US
Practice Address - Phone:818-837-6830
Practice Address - Fax:818-837-6832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79982207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G91602Medicare UPIN