Healthcare Provider Details

I. General information

NPI: 1104248871
Provider Name (Legal Business Name): AIRE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2014
Last Update Date: 06/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 S BUENA VISTA ST STE 330
BURBANK CA
91505
US

IV. Provider business mailing address

191 S BUENA VISTA ST STE 330
BURBANK CA
91505-4554
US

V. Phone/Fax

Practice location:
  • Phone: 818-561-4533
  • Fax: 818-561-4534
Mailing address:
  • Phone: 818-561-4533
  • Fax: 818-561-4534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KRIKOR HOVSEP MANOUKIAN
Title or Position: OWNER/PARTNER
Credential: M.D.
Phone: 818-561-4533