| Khachatrian Medical Corp | |
|
12643 Sherman Way Ste I North Hollywood CA 91605-5272 | |
| (818) 759-0095 | |
| (818) 759-0049 |
| Full Name | Khachatrian Medical Corp |
|---|---|
| Speciality | Clinic/Center |
| Location | 12643 Sherman Way Ste I, North Hollywood, California |
| Authorized Official Name and Position | Marina Khachatrian (PRESIDENT) |
| Authorized Official Contact | 8187590095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Khachatrian Medical Corp 12643 Sherman Way Ste I North Hollywood CA 91605-5272 Ph: (818) 759-0095 | Khachatrian Medical Corp 12643 Sherman Way Ste I North Hollywood CA 91605-5272 Ph: (818) 759-0095 |
| NPI Number | 1225348006 |
|---|---|
| Provider Enumeration Date | 10/14/2010 |
| Last Update Date | 12/07/2010 |
| Medicare PECOS PAC ID | 4284821513 |
|---|---|
| Medicare Enrollment ID | O20101213000163 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225348006 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A69378 (California) | Primary |
| Provider Name | Marina Khachatrian |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487738399 PECOS PAC ID: 4082801329 Enrollment ID: I20101213000223 |
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