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General NPI Number Information
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NPI Number | 1972679280
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTH MEDICAL GROUP INC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 401 S GLENOAKS BLVD #101
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City | BURBANK
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State | CA
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Zip | 91502
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Country | US
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Telephone | 818-848-1555
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Fax | 818-842-9323
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Provider Business Mailing Address
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Address Line | 401 S GLENOAKS BLVD #101
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City | BURBANK
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State | CA
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Zip | 91502
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Country | US
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Telephone | 818-848-1555
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Fax | 818-842-9323
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAKOP GEVORKYAN
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Credential | MD
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Telephone | 818-848-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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