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General NPI Number Information
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NPI Number | 1417496332
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Entity Type | Organization
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Legal Business Name | ARMEN NERCESSIAN DO INC
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 1710 E WASHINGTON BLVD
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City | PASADENA
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State | CA
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Zip | 91104-2751
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Country | US
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Telephone | 626-345-9022
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Fax | 626-345-9019
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Provider Business Mailing Address
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Address Line | 1710 E WASHINGTON BLVD
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City | PASADENA
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State | CA
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Zip | 91104-2751
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Country | US
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Telephone | 626-345-9022
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Fax | 626-345-9019
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | DR. ARMEN YEGHIA NERCESSIAN
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Credential | DO
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Telephone | 626-345-9022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 20A6784
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License Number State | CA
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