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General NPI Number Information
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NPI Number | 1477795029
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Entity Type | Organization
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Legal Business Name | TALENE CHURUKIAN, D.O., M.P.H., A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/28/2009
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 630 S RAYMOND AVE 310
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-344-0430
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Fax | 626-956-0565
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Provider Business Mailing Address
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Address Line | 630 S RAYMOND AVE 310
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City | PASADENA
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State | CA
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Zip | 91105-3278
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Country | US
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Telephone | 626-344-0430
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Fax | 626-956-0565
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Authorized Official
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Title or Position | DIRECTOR
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Name | TALENE CHURUKIAN
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Credential | D.O., M.P.H.
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Telephone | 818-602-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A9346
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 20A9346
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License Number State | CA
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