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General NPI Number Information
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NPI Number | 1710408703
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Entity Type | Organization
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Legal Business Name | HARRY HAROUTUNIAN MD A PROFESSIONAL CORP
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 06/29/2017
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Provider Practice Location Address
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Address Line | 41750 RANCHO LAS PALMAS DR STE B1
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-5512
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Country | US
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Telephone | 760-797-7315
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Fax |
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Provider Business Mailing Address
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Address Line | 41750 RANCHO LAS PALMAS DR STE B1
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-5512
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRY HAROUTUNIAN
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Credential | MD
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Telephone | 760-797-7315
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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 | G84257
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License Number State | CA
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