Provider Demographics
NPI:1740585512
Name:BAGDASSARIAN, ARMEN
Entity Type:Individual
Prefix:
First Name:ARMEN
Middle Name:
Last Name:BAGDASSARIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 S MADISON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91016-2533
Mailing Address - Country:US
Mailing Address - Phone:818-913-3557
Mailing Address - Fax:818-955-5788
Practice Address - Street 1:503 S MADISON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-2533
Practice Address - Country:US
Practice Address - Phone:818-913-3557
Practice Address - Fax:818-955-5788
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver