Provider Demographics
NPI:1922751114
Name:MELKONYAN, ILONA (HAD)
Entity Type:Individual
Prefix:
First Name:ILONA
Middle Name:
Last Name:MELKONYAN
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5555 GARDEN GROVE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-8234
Mailing Address - Country:US
Mailing Address - Phone:714-898-5732
Mailing Address - Fax:
Practice Address - Street 1:1127 WILSHIRE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3904
Practice Address - Country:US
Practice Address - Phone:213-481-1295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8725237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist