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NPI Code Detail

MEDICARE: GRIGOR GREG CHUKURYAN

MEDICARE:   GRIGOR GREG CHUKURYAN
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
1235Z00000XSpeech-Language Pathologist
2103K00000XBehavior AnalystCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18182841157OTHERCAPHONE NUMBER
2D6974189OTHERCADRIVERS LICENSE

General Provider Information

NPI Number : 1891209904
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRIGOR GREG CHUKURYAN
Provider Business Mailing Address
First Line : 6502 TEESDALE AVE
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-1249
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6502 TEESDALE AVE
Second Line :
City : NORTH HOLLYWOOD
State : CA
Zip : 91606-1249
Country : US
Telephone Number : 818-284-1157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2017
Last Update Date : 06/16/2018

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Directions to “ GRIGOR GREG CHUKURYAN ” Practice Location

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