| Aosta Clinic Inc | |
|
800 S Central Ave Ste 207 Glendale CA 91204-4388 | |
| (818) 395-3778 | |
| (818) 697-9099 |
| Full Name | Aosta Clinic Inc |
|---|---|
| Speciality | Psychologist |
| Location | 800 S Central Ave Ste 207, Glendale, California |
| Authorized Official Name and Position | Vahe Sukiasyan (PRESIDENT) |
| Authorized Official Contact | 8183953778 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aosta Clinic Inc 800 S Central Ave Ste 207 Glendale CA 91204-4388 Ph: (818) 395-3778 | Aosta Clinic Inc 800 S Central Ave Ste 207 Glendale CA 91204-4388 Ph: (818) 395-3778 |
| NPI Number | 1629772223 |
|---|---|
| Provider Enumeration Date | 03/28/2023 |
| Last Update Date | 03/28/2023 |
| Certification Date | 03/28/2023 |
| Medicare PECOS PAC ID | 2668837238 |
|---|---|
| Medicare Enrollment ID | O20230503003324 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629772223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Vahe Sukiasyan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982839437 PECOS PAC ID: 3375798796 Enrollment ID: I20150901003186 |
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