Healthcare Provider Details

I. General information

NPI: 1780954826
Provider Name (Legal Business Name): ARTIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2012
Last Update Date: 01/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 CHESTER ST APT 1
GLENDALE CA
91203-1596
US

IV. Provider business mailing address

345 CHESTER ST APT 1
GLENDALE CA
91203-1596
US

V. Phone/Fax

Practice location:
  • Phone: 818-445-0892
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ARTIN SAHAKIAN
Title or Position: OWNER
Credential:
Phone: 818-445-0892