Individual
EDGAR ALBERTOVICH KHACHATRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1227 CAMPBELL ST, GLENDALE, CA 91207-1445
(747) 228-4111
Mailing address
1227 CAMPBELL ST, GLENDALE, CA 91207-1445
(747) 228-4111
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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