Healthcare Provider Details
I. General information
NPI: 1477558120
Provider Name (Legal Business Name): ARAM ISAIANTS D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/18/2005
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 N CENTRAL AVE STE 900
GLENDALE CA
91203-3905
US
IV. Provider business mailing address
500 N CENTRAL AVE STE 900
GLENDALE CA
91203-3905
US
V. Phone/Fax
- Phone: 818-244-1732
- Fax: 818-244-1733
- Phone: 818-244-1732
- Fax: 818-244-1733
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | E4152 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: