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General NPI Number Information
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NPI Number | 1811023708
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Entity Type | Organization
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Legal Business Name | JIRAIR KONIALIAN MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18546 ROSCOE BLVD SUITE 220
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5455
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Country | US
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Telephone | 818-886-0600
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Fax | 818-701-8100
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Provider Business Mailing Address
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Address Line | 18546 ROSCOE BLVD SUITE 220
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City | NORTHRIDGE
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State | CA
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Zip | 91324-5455
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Country | US
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Telephone | 818-886-0600
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Fax | 818-701-8100
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JIRAIR KONIALIAN
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Credential | M.D.,
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Telephone | 818-886-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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