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General NPI Number Information
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NPI Number | 1972651339
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Entity Type | Organization
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Legal Business Name | RICHARD H HAVUNJIAN MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 1510 S CENTRAL AVE STE 530
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City | GLENDALE
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State | CA
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Zip | 91204-2542
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Country | US
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Telephone | 818-548-5858
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Fax | 818-500-8355
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Provider Business Mailing Address
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Address Line | 1510 S CENTRAL AVE STE 530
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City | GLENDALE
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State | CA
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Zip | 91204-2542
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Country | US
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Telephone | 818-548-5858
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Fax | 818-500-8355
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RICHARD HRATCHIA HAVUNJIAN
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Credential | MD
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Telephone | 818-548-5858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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