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General NPI Number Information
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NPI Number | 1609193978
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Entity Type | Individual
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Provider Name | LARA G SHIRIKJIAN D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 2158 W 190TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-6103
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Country | US
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Telephone | 310-598-1236
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1544
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City | TORRANCE
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State | CA
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Zip | 90505-0544
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Country | US
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Telephone | 310-598-1236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 20A12112
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License Number State | CA
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