Healthcare Provider Details

I. General information

NPI: 1073941829
Provider Name (Legal Business Name): KHEMICHIAN MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2013
Last Update Date: 10/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 N VERDUGO RD 300
GLENDALE CA
91208-1219
US

IV. Provider business mailing address

3600 N VERDUGO RD 300
GLENDALE CA
91208-1219
US

V. Phone/Fax

Practice location:
  • Phone: 818-209-4906
  • Fax:
Mailing address:
  • Phone: 818-209-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA117900
License Number StateCA

VIII. Authorized Official

Name: ARBI KHEMICHIAN
Title or Position: OPHTHALMOLOGY
Credential: MD
Phone: 818-209-4906