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Individual

MR. GEGHAM ATANESYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2938 E NILES AVE, FRESNO, CA 93720-4960
(559) 348-7989
(559) 297-4104
Mailing address
2938 E NILES AVE, FRESNO, CA 93720-4960
(559) 348-7989
(559) 297-4104

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
8V90774
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A9850966
WORKERS COMPENSATION
CA
Enumeration date
09/30/2014
Last updated
09/30/2014
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