Organization
STAR REGISTRY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANAHIT KHUDAGULUYAN (OWNER)
(323) 656-2449
Entity
Organization
Contact information
Practice address
936 E GREEN ST, SUITE 110, PASADENA, CA 91106-2900
(323) 656-2449
(323) 656-1464
Mailing address
PO BOX 92045, PASADENA, CA 91109-2045
(323) 656-2449
(323) 656-1464
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
07/24/2010
Last updated
07/24/2010
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