=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801904693
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARMI CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 W LEMON AVE STE 8
-----------------------------------------------------
City | MONROVIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91016-5112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-471-9079
-----------------------------------------------------
Fax | 626-471-9092
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50 W LEMON AVE STE 8
-----------------------------------------------------
City | MONROVIA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91016-5112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-471-9079
-----------------------------------------------------
Fax | 626-471-9092
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MIKAYEL MNATSAKANYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-471-9079
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 302R00000X
-----------------------------------------------------
Taxonomy Name | Health Maintenance Organization
-----------------------------------------------------
License Number | TG 497
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------