MEDICARE: NARINE MALKHASYAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1295171213
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARINE MALKHASYAN

Provider Business Mailing Address
First Line	:	3825 SKY VIEW LN
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91214-1006
Country	:	US
Telephone Number	:	818-266-6959
Fax Number	:

Provider Business Practice Location Address
First Line	:	3825 SKY VIEW LN
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91214-1006
Country	:	US
Telephone Number	:	818-266-6959
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2013
Last Update Date	:	05/16/2013

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