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General NPI Number Information
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NPI Number | 1104118389
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Entity Type | Organization
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Legal Business Name | JIVAN MELIKIAN M D. INC
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Dates
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Enumeration Date | 05/06/2011
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 1530 E CHEVY CHASE DR SUITE 206
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City | GLENDALE
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State | CA
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Zip | 91206-4163
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Country | US
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Telephone | 818-546-8644
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Fax | 818-546-2494
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Provider Business Mailing Address
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Address Line | 1530 E CHEVY CHASE DR SUITE 206
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City | GLENDALE
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State | CA
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Zip | 91206-4163
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Country | US
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Telephone | 818-546-8644
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Fax | 818-546-2494
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JIVAN MELIKIAN
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Credential | M.D.
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Telephone | 818-546-8644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A45112
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License Number State | CA
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