Provider Demographics
NPI:1548211899
Name:BARSEGYAN, ARSINE (MD)
Entity Type:Individual
Prefix:
First Name:ARSINE
Middle Name:
Last Name:BARSEGYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2504
Mailing Address - Country:US
Mailing Address - Phone:818-551-1323
Mailing Address - Fax:818-551-0074
Practice Address - Street 1:1202 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2504
Practice Address - Country:US
Practice Address - Phone:818-551-1323
Practice Address - Fax:818-551-0074
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84731207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A847310Medicaid
CA00A847310Medicaid
CAA84731Medicare PIN