MEDICARE: DR. ARAM MKHITARIAN D.O.

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	207R00000X	Internal Medicine Physician	5101017957	MI
2	207R00000X	Internal Medicine Physician	20A12274	CA

General Provider Information

NPI Number	:	1952565301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARAM MKHITARIAN D.O.

Provider Business Mailing Address
First Line	:	2904 THERESA DR STE 3
Second Line	:
City	:	NEWBURY PARK
State	:	CA
Zip	:	91320-3152
Country	:	US
Telephone Number	:	805-410-4566
Fax Number	:

Provider Business Practice Location Address
First Line	:	2904 THERESA DR
Second Line	:
City	:	NEWBURY PARK
State	:	CA
Zip	:	91320-3137
Country	:	US
Telephone Number	:	805-410-4566
Fax Number	:

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

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	05/20/2020

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