| Hrach Khudatyan Md Inc | |
|
134 N Glendale Ave Glendale CA 91206-4451 | |
| (818) 662-8858 | |
| (818) 662-8987 |
| Full Name | Hrach Khudatyan Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 134 N Glendale Ave, Glendale, California |
| Authorized Official Name and Position | Hrach Khudatyan (DOCTOR) |
| Authorized Official Contact | 8186628858 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hrach Khudatyan Md Inc 134 N Glendale Ave Glendale CA 91206-4451 Ph: (818) 662-8858 | Hrach Khudatyan Md Inc 134 N Glendale Ave Glendale CA 91206-4451 Ph: (818) 662-8858 |
| NPI Number | 1801107511 |
|---|---|
| Provider Enumeration Date | 06/28/2010 |
| Last Update Date | 09/15/2014 |
| Medicare PECOS PAC ID | 9537351739 |
|---|---|
| Medicare Enrollment ID | O20110127000424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801107511 | NPI | - | NPPES |
| 00A608711 | Medicaid | CA | |
| A60871 | Other | CA | MEDICARE ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A60871 (California) | Primary |
| Provider Name | Hrach Khudatyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720050032 PECOS PAC ID: 4284700055 Enrollment ID: I20101006000859 |
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