Provider Demographics
NPI:1538488333
Name:SUKYAS, MELINA KARABETYAN (PA)
Entity Type:Individual
Prefix:
First Name:MELINA
Middle Name:KARABETYAN
Last Name:SUKYAS
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1500 S CENTRAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2530
Mailing Address - Country:US
Mailing Address - Phone:818-242-0475
Mailing Address - Fax:818-662-0260
Practice Address - Street 1:1500 S CENTRAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2530
Practice Address - Country:US
Practice Address - Phone:818-242-0475
Practice Address - Fax:818-662-0260
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2017-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA17023363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical