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Organization

MCLA PSYCHIATRIC MEDICAL GROUP A PROFESSIONAL CORPORATION

Active
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Organization

MCLA PSYCHIATRIC MEDICAL GROUP A PROFESSIONAL CORPORATION

Active
Other names
MCLA Psychiatric Medical Group
Organization subpart
No

Provider details

NPI number
Authorized official
LUKAS ALEXANIAN MD (PRESIDENT)
(818) 240-0340
Entity
Organization

Contact information

Practice address
1560 E CHEVY CHASE DRIVE, SUITE 130, GLENDALE, CA 91206-4140
(818) 240-0340
(818) 545-7672
Mailing address
1560 E CHEVY CHASE DRIVE, SUITE 130, GLENDALE, CA 91206-4140
(818) 240-0340
(818) 545-7672

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—

Other

Enumeration date
03/07/2006
Last updated
11/23/2015
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