Provider Demographics
NPI:1720003098
Name:MINASSIAN, HAIG V (MD)
Entity Type:Individual
Prefix:
First Name:HAIG
Middle Name:V
Last Name:MINASSIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12291 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2500
Mailing Address - Country:US
Mailing Address - Phone:562-696-9265
Mailing Address - Fax:877-887-8750
Practice Address - Street 1:12291 WASHINGTON BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2500
Practice Address - Country:US
Practice Address - Phone:562-698-0679
Practice Address - Fax:562-698-5046
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG25816207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G258161Medicaid
CA00G258161Medicaid
CAWG25816FMedicare PIN
CA00G258161Medicaid