Provider Demographics
NPI:1669844791
Name:SIRAK DARBINIAN A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SIRAK DARBINIAN A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIRAK
Authorized Official - Middle Name:
Authorized Official - Last Name:DARBINIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-439-0724
Mailing Address - Street 1:610 S MAIN ST
Mailing Address - Street 2:PH204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90014-2009
Mailing Address - Country:US
Mailing Address - Phone:949-439-0724
Mailing Address - Fax:661-287-3951
Practice Address - Street 1:610 S MAIN ST
Practice Address - Street 2:PH204
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90014-2009
Practice Address - Country:US
Practice Address - Phone:949-439-0724
Practice Address - Fax:661-287-3951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA102585207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1508055039OtherPERSONAL NPI