# STEPHAN GRIGORIAN MD INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Glenpath Diagnostics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689980914
- **Authorized official:** DR. STEPHAN ROBERT GRIGORIAN M.D. (OWNER / PHYSICIAN)
- **Authorized official phone:** (818) 507-1200

## Contact information

- **Practice address:** 800 S CENTRAL AVE, SUITE 208, GLENDALE, CA 91204-4370
- **Practice address phone:** (818) 507-1200
- **Practice address fax:** (818) 507-1200
- **Mailing address:** 800 S CENTRAL AVE, SUITE 208, GLENDALE, CA 91204-4370
- **Mailing address phone:** (818) 507-1200
- **Mailing address fax:** (818) 507-1200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | A88170 | CA | Yes |

## Other

- **Enumeration date:** 08/24/2010
- **Last updated:** 04/03/2013