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General NPI Number Information
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NPI Number | 1609184142
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Entity Type | Organization
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Legal Business Name | SETHIAN MD, INC
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Dates
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Enumeration Date | 09/17/2010
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 1028 N LAKE AVE STE 103
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City | PASADENA
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State | CA
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Zip | 91104-4570
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Country | US
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Telephone | 626-797-3378
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Fax | 626-797-4812
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Provider Business Mailing Address
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Address Line | 1028 N LAKE AVE STE 103
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City | PASADENA
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State | CA
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Zip | 91104-4570
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Country | US
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Telephone | 626-797-3378
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Fax | 626-797-4812
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Authorized Official
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Title or Position | PRESIDANT
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Name | DR. NUBAR ARAM SETHIAN
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Credential | M.D.
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Telephone | 626-797-3378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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