Healthcare Provider Details

I. General information

NPI: 1295703320
Provider Name (Legal Business Name): STEVEN D KAMAJIAN D.O
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 MONTROSE AVE SUITE E
MONTROSE CA
91020-1546
US

IV. Provider business mailing address

2103 MONTROSE AVE SUITE E
MONTROSE CA
91020-1546
US

V. Phone/Fax

Practice location:
  • Phone: 818-957-2007
  • Fax:
Mailing address:
  • Phone: 818-957-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A4674
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: