Healthcare Provider Details

I. General information

NPI: 1730761453
Provider Name (Legal Business Name): CHRISTOPHER CHAMANADJIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 E 120TH ST
LOS ANGELES CA
90059-3051
US

IV. Provider business mailing address

21810 NORMANDIE AVE FL 1
TORRANCE CA
90502-2047
US

V. Phone/Fax

Practice location:
  • Phone: 323-563-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberPTL5680
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPTL5680
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberPTL5680
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number194014
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: