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Individual

MR. HERACH YADEGARIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
800 S. CENTRAL AVE., SUITE 308, GLENDALE, CA 91204-4644
(818) 240-8767
(818) 502-0254
Mailing address
800 S. CENTRAL AVE., SUITE 308, GLENDALE, CA 91204-4644
(818) 240-8767
(818) 502-0254

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A49305
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A493050
CA
Enumeration date
12/12/2006
Last updated
09/04/2009
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