Organization
BIXBY LASER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNA GEVORGYAN M.D. (OWNER)
(562) 896-4809
Entity
Organization
Contact information
Practice address
3650 ATLANTIC AVE, LONG BEACH, CA 90807-3418
(562) 896-4809
Mailing address
3650 ATLANTIC AVE, LONG BEACH, CA 90807-3418
(562) 896-4809
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
—
—
207VX0000X
Obstetrics Physician
—
—
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295960508
NPI
CA
Enumeration date
02/20/2017
Last updated
02/20/2017
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