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General NPI Number Information
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NPI Number | 1346091238
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Entity Type | Organization
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Legal Business Name | ACTIVE SPORTS MEDICINE CLINIC
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 435 ARDEN AVE STE 340
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City | GLENDALE
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State | CA
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Zip | 91203-4017
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Country | US
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Telephone | 818-252-9676
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Fax |
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Provider Business Mailing Address
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Address Line | 435 ARDEN AVE STE 340
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City | GLENDALE
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State | CA
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Zip | 91203-4017
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Country | US
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Telephone | 818-252-9676
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | ARGIN HARITOUNIAN
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Credential | DO
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Telephone | 818-319-2828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0010X
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Taxonomy Name | Sports Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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