Provider Demographics
NPI:1720357510
Name:KHACHATOORIANS, ARINEH (AVD)
Entity Type:Individual
Prefix:
First Name:ARINEH
Middle Name:
Last Name:KHACHATOORIANS
Suffix:
Gender:F
Credentials:AVD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2472
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92659-1472
Mailing Address - Country:US
Mailing Address - Phone:949-574-4638
Mailing Address - Fax:949-574-4680
Practice Address - Street 1:446 OLD NEWPORT BLVD
Practice Address - Street 2:STE 100
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4246
Practice Address - Country:US
Practice Address - Phone:949-631-4327
Practice Address - Fax:949-631-0409
Is Sole Proprietor?:No
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2807231H00000X
CAHA7667237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist