Healthcare Provider Details

I. General information

NPI: 1841624384
Provider Name (Legal Business Name): RUBEN G CHLDRYAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RUBEN CHLDRIAN D.C.

II. Dates (important events)

Enumeration Date: 08/31/2013
Last Update Date: 08/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 W BROADWAY SUITE 125
GLENDALE CA
91204-1022
US

IV. Provider business mailing address

6235 MAMMOTH AVE
VALLEY GLEN CA
91401-2919
US

V. Phone/Fax

Practice location:
  • Phone: 818-237-6602
  • Fax:
Mailing address:
  • Phone: 818-237-6602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number32702
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: