Individual
JACOB M. KHUSHIGIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5431 E LANE AVE, FRESNO, CA 93727
(559) 250-6759
Mailing address
5431 E LANE AVE, FRESNO, CA 93727-5335
(559) 250-6759
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G63744
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G637440
—
CA
Enumeration date
08/10/2006
Last updated
01/25/2019
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