Evlyn Avanessian, Md, Inc | |
3628 Foothill Blvd La Crescenta CA 91214-1724 | |
(818) 296-9601 | |
(818) 296-9602 |
Full Name | Evlyn Avanessian, Md, Inc |
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Speciality | Family Medicine |
Location | 3628 Foothill Blvd, La Crescenta, California |
Authorized Official Name and Position | Evlyn Avanessian (MD) |
Authorized Official Contact | 8183523146 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Evlyn Avanessian, Md, Inc 3628 Foothill Blvd La Crescenta CA 91214-1724 Ph: (818) 296-9601 | Evlyn Avanessian, Md, Inc 3628 Foothill Blvd La Crescenta CA 91214-1724 Ph: (818) 296-9601 |
NPI Number | 1457768731 |
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Provider Enumeration Date | 07/17/2014 |
Last Update Date | 10/10/2023 |
Medicare PECOS PAC ID | 5496974321 |
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Medicare Enrollment ID | O20140908002522 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457768731 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
261Q00000X | Clinic/center | A127456 (California) | Secondary |
Provider Name | Evlyn Avanessian |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1295020709 PECOS PAC ID: 6305065236 Enrollment ID: I20140908002604 |
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