Healthcare Provider Details

I. General information

NPI: 1306981253
Provider Name (Legal Business Name): VAHAN CEPKINIAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 12/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 W EULALIA ST STE 300
GLENDALE CA
91204-2849
US

IV. Provider business mailing address

PO BOX 27206
LOS ANGELES CA
90027-0206
US

V. Phone/Fax

Practice location:
  • Phone: 818-547-0608
  • Fax: 818-547-0606
Mailing address:
  • Phone: 213-385-0675
  • Fax: 213-365-6429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA71238
License Number StateCA

VIII. Authorized Official

Name: VAHAN CEPKINIAN
Title or Position: OWNER
Credential: M.D.
Phone: 818-547-0608