Provider Demographics
NPI:1942448220
Name:MANUKIAN, PIERRE (MD)
Entity Type:Individual
Prefix:
First Name:PIERRE
Middle Name:
Last Name:MANUKIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 W OLIVE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2459
Mailing Address - Country:US
Mailing Address - Phone:818-736-5553
Mailing Address - Fax:818-875-1563
Practice Address - Street 1:1624 W OLIVE AVE
Practice Address - Street 2:SUITE F
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2459
Practice Address - Country:US
Practice Address - Phone:818-736-5553
Practice Address - Fax:818-875-1563
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA100998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine