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NPI Code Detail

MEDICARE: ELVIRA KUCHURYAN BCBA

MEDICARE: ELVIRA KUCHURYAN BCBA
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
1103K00000XBehavior Analyst1-14-16223

General Provider Information

NPI Number : 1821403007
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELVIRA KUCHURYAN BCBA
Provider Business Mailing Address
First Line : 2550 N HOLLYWOOD WAY STE 102
Second Line :
City : BURBANK
State : CA
Zip : 91505-5031
Country : US
Telephone Number : 866-278-5011
Fax Number :
Provider Business Practice Location Address
First Line : 2550 N HOLLYWOOD WAY STE 102
Second Line :
City : BURBANK
State : CA
Zip : 91505-5031
Country : US
Telephone Number : 866-278-5011
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2014
Last Update Date : 06/25/2014

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