MEDICARE: DR. STELLA ASTHIG ATANASIAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	A45083	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245372135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STELLA ASTHIG ATANASIAN M.D.

Provider Business Mailing Address
First Line	:	2544 E WASHINGTON BLVD
Second Line	:	SUITE B
City	:	PASADENA
State	:	CA
Zip	:	91107-1452
Country	:	US
Telephone Number	:	626-794-3470
Fax Number	:	626-794-1088

Provider Business Practice Location Address
First Line	:	2544 E WASHINGTON BLVD
Second Line	:	SUITE B
City	:	PASADENA
State	:	CA
Zip	:	91107-1452
Country	:	US
Telephone Number	:	626-794-3470
Fax Number	:	626-794-1088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/09/2007

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