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Organization
MISSAK KLTCHIAN MD INC.
Active
Organization
MISSAK KLTCHIAN MD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MISSAK KLTCHIAN MD (MD / PRESIDENT)
(323) 661-4500
Entity
Organization
Contact information
Practice address
4645 HOLLYWOOD BLVD STE 2/4, LOS ANGELES, CA 90027-5455
(323) 661-4500
(323) 661-3260
Mailing address
4645 HOLLYWOOD BLVD STE 2/4, LOS ANGELES, CA 90027-5455
(323) 661-4500
(323) 661-3260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A52368
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A52368
—
CA
01
—
1255359840
MEDICARE
CA
01
—
1578901237
MEDICARE
CA
Enumeration date
07/02/2018
Last updated
07/02/2018
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