MEDICARE: TIGRAN GARABEKYAN, MD CORPORATION

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	261QM2500X	Medical Specialty Clinic/Center

General Provider Information

NPI Number	:	1982063509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIGRAN GARABEKYAN, MD CORPORATION

Provider Business Mailing Address
First Line	:	10640 RIVERSIDE DR
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2319
Country	:	US
Telephone Number	:	818-755-6500
Fax Number	:

Provider Business Practice Location Address
First Line	:	10640 RIVERSIDE DR
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2319
Country	:	US
Telephone Number	:	818-755-6500
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CLARA PRUETT
Credential	:
Telephone Number	:	818-755-6500

Provider Enumeration Date	:	02/11/2016
Last Update Date	:	06/16/2016

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