Provider Demographics
NPI:1811023708
Name:JIRAIR KONIALIAN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JIRAIR KONIALIAN MEDICAL CORPORATION
Other - Org Name:WOMENS HEALTHCARE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JIRAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KONIALIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:818-886-0600
Mailing Address - Street 1:18546 ROSCOE BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-5455
Mailing Address - Country:US
Mailing Address - Phone:818-886-0600
Mailing Address - Fax:818-701-8100
Practice Address - Street 1:18546 ROSCOE BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-5455
Practice Address - Country:US
Practice Address - Phone:818-886-0600
Practice Address - Fax:818-701-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center