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Individual

DR. LEVON ANTOSSYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1204 S CENTRAL AVE, GLENDALE, CA 91204-2504
(818) 551-0001
Mailing address
1204 S CENTRAL AVE, GLENDALE, CA 91204-2504
(818) 551-0001

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A0053324
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A533241
CA
Enumeration date
11/26/2007
Last updated
02/29/2012
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