Healthcare Provider Details

I. General information

NPI: 1205967916
Provider Name (Legal Business Name): NUNE SIMONIAN, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 01/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 ARDEN AVE STE 550
GLENDALE CA
91203-4026
US

IV. Provider business mailing address

435 ARDEN AVE STE 550
GLENDALE CA
91203-4026
US

V. Phone/Fax

Practice location:
  • Phone: 818-242-3916
  • Fax: 818-242-4586
Mailing address:
  • Phone: 818-242-3916
  • Fax: 818-242-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA554102
License Number StateCA

VIII. Authorized Official

Name: NUNE SIMONIAN
Title or Position: OWNER
Credential: M.D.
Phone: 818-242-3916