Organization
MCSSG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARDIROS MIHRANIAN M.D. (GENERAL SURGEON)
(818) 240-1820
Entity
Organization
Contact information
Practice address
1510 S CENTRAL AVE STE 100, GLENDALE, CA 91204-2582
(818) 240-1820
(818) 240-1021
Mailing address
1510 S CENTRAL AVE STE 100, GLENDALE, CA 91204-2582
(818) 240-1820
(818) 240-1021
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17404
CA
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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