Provider Demographics
NPI:1770273666
Name:PKHRIKYAN, ADRINEH (PA-C)
Entity type:Individual
Prefix:
First Name:ADRINEH
Middle Name:
Last Name:PKHRIKYAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7640 TAMPA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335
Mailing Address - Country:US
Mailing Address - Phone:818-718-1600
Mailing Address - Fax:
Practice Address - Street 1:7640 TAMPA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335
Practice Address - Country:US
Practice Address - Phone:818-718-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-09-27
Deactivation Date:2023-09-12
Deactivation Code:
Reactivation Date:2023-09-27
Provider Licenses
StateLicense IDTaxonomies
CA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical