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General NPI Number Information
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NPI Number | 1497084958
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Entity Type | Organization
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Legal Business Name | ELDA AGHAIAN, MD INC
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Dates
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Enumeration Date | 12/12/2009
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Last Update Date | 12/12/2009
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Provider Practice Location Address
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Address Line | 1560 E CHEVY CHASE DR STE 220
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City | GLENDALE
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State | CA
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Zip | 91206-4140
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Country | US
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Telephone | 818-970-8525
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Fax | 818-484-2243
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Provider Business Mailing Address
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Address Line | 100 W BROADWAY STE 950
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City | GLENDALE
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State | CA
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Zip | 91210-1209
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Country | US
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Telephone | 818-970-8525
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Fax | 818-484-2243
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELDA AGHAIAN
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Credential | M.D.
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Telephone | 818-970-8525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A93307
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License Number State | CA
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