Provider Demographics
NPI:1982017760
Name:ARMEN DERBOGHOSSIANS, MD INC
Entity Type:Organization
Organization Name:ARMEN DERBOGHOSSIANS, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DERBOGHOSSIANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-507-4228
Mailing Address - Street 1:116 S LOUISE ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1025
Mailing Address - Country:US
Mailing Address - Phone:818-507-4228
Mailing Address - Fax:818-507-4308
Practice Address - Street 1:116 S LOUISE ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1025
Practice Address - Country:US
Practice Address - Phone:818-507-4228
Practice Address - Fax:818-507-4308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty