Healthcare Provider Details

I. General information

NPI: 1619122991
Provider Name (Legal Business Name): ARMEN K. GOENJIAN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 E ATHERTON ST
LONG BEACH CA
90815-3700
US

IV. Provider business mailing address

4525 E ATHERTON ST
LONG BEACH CA
90815-3700
US

V. Phone/Fax

Practice location:
  • Phone: 562-961-0155
  • Fax: 562-961-0161
Mailing address:
  • Phone: 562-961-0155
  • Fax: 562-961-0161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC34978
License Number StateCA

VIII. Authorized Official

Name: ARMEN K GOENJIAN
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 562-961-0155