Provider Demographics
NPI:1588632855
Name:GOENJIAN, ARMEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:K
Last Name:GOENJIAN
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 1:4525 E ATHERTON ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-3700
Mailing Address - Country:US
Mailing Address - Phone:562-961-0155
Mailing Address - Fax:562-961-0161
Practice Address - Street 1:4525 E ATHERTON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-3700
Practice Address - Country:US
Practice Address - Phone:562-961-0155
Practice Address - Fax:562-961-0161
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC349782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA87771Medicare UPIN
CAC34978Medicare ID - Type Unspecified