Individual
SIRANOUSH H KEVORKIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8781 VAN NUYS BLVD, PANORAMA CITY, CA 91402-2406
(818) 920-0808
(818) 920-6603
Mailing address
425 PALM DRIVE, UNIT 1, GLENDALE, CA 91202
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A35663
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A356630
—
CA
Enumeration date
12/22/2006
Last updated
07/08/2007
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