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General NPI Number Information
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NPI Number | 1891870796
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Entity Type | Individual
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Provider Name | DR. HASMIK AMBARTSUMYAN
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 05/13/2014
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Provider Practice Location Address
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Address Line | 5222 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90027-5710
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Country | US
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Telephone | 323-666-2222
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Fax | 323-666-2170
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Provider Business Mailing Address
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Address Line | 5262 LOS DIEGOS WAY
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City | LOS ANGELES
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State | CA
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Zip | 90027-1016
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Country | US
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Telephone | 323-467-6437
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Fax | 323-666-2170
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 42518
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License Number State | CA
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