Organization
CORE GERIATRIC MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE AYVAZYAN MSPA-C (OWNER)
(818) 723-8804
Entity
Organization
Contact information
Practice address
1505 S GLENDALE AVE, GLENDALE, CA 91205-3315
(818) 758-9588
(818) 975-5217
Mailing address
1505 S GLENDALE AVE, GLENDALE, CA 91205-3315
(818) 758-9588
(818) 975-5217
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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