Individual
GAGIK IGNATENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 E HARVARD ST STE 203A, GLENDALE, CA 91205-1045
(818) 818-4697
Mailing address
415 E HARVARD ST STE 203A, GLENDALE, CA 91205-1045
(818) 818-4697
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
CVOP1915290
CA
Other
Enumeration date
04/01/2021
Last updated
04/01/2021
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