MEDICARE: DR. GEORGE HAROUTIOUN SABOUNJIAN 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	2084P0800X	Psychiatry Physician	A49343	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	:	1699882779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE HAROUTIOUN SABOUNJIAN M.D.

Provider Business Mailing Address
First Line	:	1142 GRAYNOLD AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91202-2019
Country	:	US
Telephone Number	:	818-241-8928
Fax Number	:	818-545-9401

Provider Business Practice Location Address
First Line	:	1030 S GLENDALE AVE STE 401
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-2866
Country	:	US
Telephone Number	:	818-241-8928
Fax Number	:	818-545-9401

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	07/09/2007

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