Healthcare Provider Details

I. General information

NPI: 1760810253
Provider Name (Legal Business Name): MICHEL BABAJANIAN, MD, FACS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2013
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK E 1700
LOS ANGELES CA
90067-2001
US

IV. Provider business mailing address

2080 CENTURY PARK E 1700
LOS ANGELES CA
90067-2001
US

V. Phone/Fax

Practice location:
  • Phone: 310-201-0728
  • Fax: 310-201-9665
Mailing address:
  • Phone: 310-201-0007
  • Fax: 310-201-5902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberG74471
License Number StateCA

VIII. Authorized Official

Name: DR. MICHEL BABAJANIAN
Title or Position: OWNER
Credential: M.D.
Phone: 310-201-0007