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General NPI Number Information
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NPI Number | 1225994114
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Entity Type | Organization
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Legal Business Name | CENTRAL COAST NEUROVASCULAR
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 1451 E CHEVY CHASE DR STE 201
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City | GLENDALE
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State | CA
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Zip | 91206-4056
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Country | US
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Telephone | 818-253-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 SPARR BLVD
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City | GLENDALE
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State | CA
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Zip | 91208-1663
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Country | US
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Telephone | 818-253-1525
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MIKAYEL GRIGORYAN
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Credential | MD
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Telephone | 650-995-3193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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