Healthcare Provider Details

I. General information

NPI: 1538553052
Provider Name (Legal Business Name): RAYMOND MELIKIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12401 WASHINGTON BLVD
WHITTIER CA
90602-1006
US

IV. Provider business mailing address

18627 BROOKHURST ST # 473
FOUNTAIN VALLEY CA
92708-6748
US

V. Phone/Fax

Practice location:
  • Phone: 562-698-0811
  • Fax:
Mailing address:
  • Phone: 714-742-2292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number125.075401
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA146711
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: