Healthcare Provider Details

I. General information

NPI: 1902964794
Provider Name (Legal Business Name): HAIG MINASSIAN M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 04/13/2017
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: 562-698-0670
  • 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: DR. HAIG V MINASSIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 562-698-0670