Provider Demographics
NPI:1710969506
Name:HAMPARIAN, MIREILLE PARTAMIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MIREILLE
Middle Name:PARTAMIAN
Last Name:HAMPARIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MIRAY
Other - Middle Name:
Other - Last Name:BARTAMIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1451 E CHEVY CHASE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4056
Mailing Address - Country:US
Mailing Address - Phone:818-409-1777
Mailing Address - Fax:818-409-1771
Practice Address - Street 1:1451 E CHEVY CHASE DR
Practice Address - Street 2:#100
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4056
Practice Address - Country:US
Practice Address - Phone:818-409-1777
Practice Address - Fax:818-409-1771
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75480207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A754800Medicaid
CA00A754800Medicaid
CAW17278AMedicare PIN
CAW17278Medicare PIN
CAWA75480CMedicare PIN