Provider Demographics
NPI:1982614392
Name:HARMONY MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:HARMONY MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELKUMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-660-2647
Mailing Address - Street 1:213 N ORANGE ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2648
Mailing Address - Country:US
Mailing Address - Phone:818-660-2647
Mailing Address - Fax:818-484-2536
Practice Address - Street 1:213 N ORANGE ST
Practice Address - Street 2:SUITE E
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2648
Practice Address - Country:US
Practice Address - Phone:818-660-2647
Practice Address - Fax:818-484-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91329207Q00000X
CAA36023207RC0000X
CAPT10100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1982614392Medicaid
CA1982614392OtherNPI
CA1982614392Medicaid