| Antranig Kelleyan | |
|
13734 Ramona Blvd Baldwin Park CA 91706-4021 | |
| (626) 960-6616 | |
| (626) 337-0047 |
| Full Name | Antranig Kelleyan |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13734 Ramona Blvd, Baldwin Park, California |
| Authorized Official Name and Position | Antranig Gary Kelleyan (OWNER DENTIST) |
| Authorized Official Contact | 6269606616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antranig Kelleyan 13734 Ramona Blvd Baldwin Park CA 91706-4021 Ph: (626) 960-6616 | Antranig Kelleyan 13734 Ramona Blvd Baldwin Park CA 91706-4021 Ph: (626) 960-6616 |
| NPI Number | 1659653970 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 09/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659653970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 52409 (California) | Primary |
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