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General NPI Number Information
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NPI Number | 1437076262
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE MIND AND MEDICINE INC.
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 3808 W RIVERSIDE DR STE 503
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City | BURBANK
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State | CA
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Zip | 91505-5301
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Country | US
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Telephone | 747-292-5257
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Fax | 747-286-7933
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Provider Business Mailing Address
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Address Line | 3808 W RIVERSIDE DR STE 503
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City | BURBANK
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State | CA
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Zip | 91505-5301
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Country | US
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Telephone | 747-292-5257
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Fax | 747-286-7933
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Authorized Official
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Title or Position | CO-FOUNDER
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Name | CHRISTOPHER KHOSHORYAN
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Credential | MD
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Telephone | 747-286-7933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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