# SAMUEL A MALAYAN MEDICAL CORP

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

## Provider details

- **NPI number:** 1407157878
- **Authorized official:** SOFYA BAKHTAMYAN (OFFICE MANAGER)
- **Authorized official phone:** (818) 550-0702

## Contact information

- **Practice address:** 610 N CENTRAL AVE, SUITE 301, GLENDALE, CA 91203-1403
- **Practice address phone:** (818) 550-0702
- **Practice address fax:** (818) 550-0705
- **Mailing address:** 610 N CENTRAL AVE, SUITE 301, GLENDALE, CA 91203-1403
- **Mailing address phone:** (818) 550-0702
- **Mailing address fax:** (818) 550-0705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | G61143 | CA | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | G61143 | CA | Yes |

## Other

- **Enumeration date:** 11/16/2010
- **Last updated:** 03/22/2011