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General NPI Number Information
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NPI Number | 1467555326
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Entity Type | Organization
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Legal Business Name | CAROLYN KASSABIAN, MD INC A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 11550 INDIAN HILLS RD SUITE 261
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City | MISSION HILLS
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State | CA
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Zip | 91345-1200
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Country | US
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Telephone | 818-838-6070
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Fax | 818-837-6832
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Provider Business Mailing Address
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Address Line | 14901 RINALDI ST SUITE 305
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City | MISSION HILLS
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State | CA
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Zip | 91345-1204
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Country | US
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Telephone | 818-838-6070
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Fax | 818-837-6832
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAROLYN M KASSABIAN
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Credential | M.D.
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Telephone | 818-838-6070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A80284
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License Number State | CA
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