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General NPI Number Information
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NPI Number | 1457776866
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Entity Type | Organization
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Legal Business Name | PIERRE MANUKIAN, M.D., INC.
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 1624 W OLIVE AVE SUITE F
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City | BURBANK
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State | CA
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Zip | 91506-2459
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Country | US
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Telephone | 747-200-6050
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Fax | 818-875-1563
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Provider Business Mailing Address
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Address Line | 1624 W OLIVE AVE SUITE F
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City | BURBANK
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State | CA
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Zip | 91506-2459
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PIERRE GEORGE MANUKIAN
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Credential | M.D.
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Telephone | 831-210-6057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A100998
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License Number State | CA
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