Organization
SAMUEL A MALAYAN MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOFYA BAKHTAMYAN (OFFICE MANAGER)
(818) 550-0702
Entity
Organization
Contact information
Practice address
610 N CENTRAL AVE, SUITE 301, GLENDALE, CA 91203-1403
(818) 550-0702
(818) 550-0705
Mailing address
610 N CENTRAL AVE, SUITE 301, GLENDALE, CA 91203-1403
(818) 550-0702
(818) 550-0705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G61143
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
G61143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G61143
MEDICARE ID
CA
Enumeration date
11/16/2010
Last updated
03/22/2011
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