Provider Demographics
NPI:1932527306
Name:MOUGHAMIAN, ARMEN JIRAIR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:JIRAIR
Last Name:MOUGHAMIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:415-600-5555
Mailing Address - Fax:415-558-7035
Practice Address - Street 1:45 CASTRO ST STE 220
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1027
Practice Address - Country:US
Practice Address - Phone:415-600-5555
Practice Address - Fax:415-558-7035
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1395002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA139500OtherSTATE MEDICAL LICENSE