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General NPI Number Information
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NPI Number | 1376835330
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Entity Type | Organization
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Legal Business Name | GREGORY H TCHEJEYAN MD INC
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 250 LOMBARD ST STE 1
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-8208
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Country | US
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Telephone | 805-495-3687
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Fax | 805-494-1828
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Provider Business Mailing Address
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Address Line | 250 LOMBARD ST STE 1
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-8208
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Country | US
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Telephone | 805-495-3687
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Fax | 805-494-1828
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Authorized Official
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Title or Position | MANAGER
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Name | SIUKE LILI
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Credential |
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Telephone | 805-495-3687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A55364
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License Number State | CA
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