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General NPI Number Information
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NPI Number | 1851887335
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Entity Type | Organization
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Legal Business Name | PRECISION SPINE & ORTHOPEDICS INC.
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 07/07/2018
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Provider Practice Location Address
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Address Line | 222 W EULALIA ST STE 309
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City | GLENDALE
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State | CA
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Zip | 91204-2851
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Country | US
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Telephone | 818-579-2929
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Fax | 818-579-2929
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Provider Business Mailing Address
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Address Line | 1200 S BRAND BLVD STE 440
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City | GLENDALE
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State | CA
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Zip | 91204-2641
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Country | US
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Telephone | 818-579-2929
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Fax | 818-579-2929
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. NICK GHAZARIAN
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Credential | DO
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Telephone | 818-579-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 20A13071
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License Number State | CA
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