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NPI 1972268316

NPI 1972268316 : BRILLIANT PHYSICIAN SERVICES INC : LA QUINTA, CA

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General NPI Number Information
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    NPI Number           |    1972268316
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    Entity Type          |    Organization 
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    Legal Business Name  |    BRILLIANT PHYSICIAN SERVICES INC 
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Dates
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    Enumeration Date     |    11/01/2021
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    Last Update Date     |    09/11/2025
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Provider Practice Location Address
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    Address Line         |    51625 DESERT CLUB DR STE 208 
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    City                 |    LA QUINTA
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    State                |    CA
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    Zip                  |    92253-2983
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    Country              |    US
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    Telephone            |    818-441-2177
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    Fax                  |    747-300-2112
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Provider Business Mailing Address
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    Address Line         |    79353 CALLE VISTA VERDE 
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    City                 |    LA QUINTA
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    State                |    CA
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    Zip                  |    92253-5950
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    Country              |    US
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    Telephone            |    818-441-2177
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    Fax                  |    747-300-2112
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    DR. MARTIN ARAYIKOVICH SAHAKYAN 
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    Credential           |    MD
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    Telephone            |    818-441-2177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207QA0401X
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    Taxonomy Name        |    Addiction Medicine (Family Medicine) Physician
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    License Number       |    
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    License Number State |    
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