Healthcare Provider Details

I. General information

NPI: 1396953733
Provider Name (Legal Business Name): KRIKOR I KALINDJIAN,MD.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N VERMONT AVE SUITE 807
LOS ANGELES CA
90027-6005
US

IV. Provider business mailing address

1300 N VERMONT AVE SUITE 807
LOS ANGELES CA
90027-6005
US

V. Phone/Fax

Practice location:
  • Phone: 323-660-5191
  • Fax: 323-660-6513
Mailing address:
  • Phone: 323-660-5191
  • Fax: 323-660-6513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA80255
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA80255
License Number StateCA

VIII. Authorized Official

Name: DR. KRIKOR ISRAEL KALINDJIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 323-660-5191