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General NPI Number Information
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NPI Number | 1275504995
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Entity Type | Organization
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Legal Business Name | JOSEPH KERENDIAN, MD, INC
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 09/29/2007
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Provider Practice Location Address
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Address Line | 17075 DEVONSHIRE ST SUITE 307
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City | NORTHRIDGE
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State | CA
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Zip | 91325-1600
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Country | US
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Telephone | 818-832-5551
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Fax | 818-832-0124
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Provider Business Mailing Address
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Address Line | 17075 DEVONSHIRE ST SUITE 307
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City | NORTHRIDGE
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State | CA
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Zip | 91325-5408
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Country | US
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Telephone | 818-832-5551
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Fax | 818-832-0124
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH KERENDIAN
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Credential | MD
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Telephone | 818-832-5551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G75439
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License Number State | CA
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