Healthcare Provider Details

I. General information

NPI: 1043378938
Provider Name (Legal Business Name): DR. MIHRAN SHIRINIAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 WILSON TER SUITE 340
GLENDALE CA
91206-4071
US

IV. Provider business mailing address

1505 WILSON TER SUITE 340
GLENDALE CA
91206-4071
US

V. Phone/Fax

Practice location:
  • Phone: 818-543-7574
  • Fax: 818-956-7609
Mailing address:
  • Phone: 818-543-7574
  • Fax: 818-956-7609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. MIHRAN H SHIRINIAN
Title or Position: M.D.
Credential: M.D.
Phone: 818-543-7574