Healthcare Provider Details

I. General information

NPI: 1720003098
Provider Name (Legal Business Name): HAIG V MINASSIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12291 WASHINGTON BLVD SUITE 102
WHITTIER CA
90606-2500
US

IV. Provider business mailing address

12291 WASHINGTON BLVD SUITE 102
WHITTIER CA
90606-2500
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-0679
  • Fax: 562-698-5046
Mailing address:
  • Phone: 562-696-9265
  • Fax: 877-887-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberG25816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: