# STEPHAN V. YACOUBIAN, M.D., A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407040744
- **Authorized official:** DR. STEPHAN VAHE YACOUBIAN M.D. (PRESIDENT)
- **Authorized official phone:** (818) 841-3936

## Contact information

- **Practice address:** 2625 W ALAMEDA AVE, SUITE 116, BURBANK, CA 91505-4806
- **Practice address phone:** (818) 841-3936
- **Practice address fax:** (818) 841-5947
- **Mailing address:** 2625 W ALAMEDA AVE, SUITE 116, BURBANK, CA 91505-4806
- **Mailing address phone:** (818) 841-3936
- **Mailing address fax:** (818) 841-5947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | A77306 | CA | Yes |

## Other

- **Enumeration date:** 08/29/2007
- **Last updated:** 06/20/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A773060 | — | CA |