Organization
MINIMALLY INVASIVE SURGICAL TEAM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE KEVORK TASHJIAN M.D. (OWNER)
(818) 265-2260
Entity
Organization
Contact information
Practice address
801 SOUTH CHEVY CHASE DRIVE, 101, GLENDALE, CA 91205
(818) 265-2260
(818) 265-2268
Mailing address
801 SOUTH CHEVY CHASE DRIVE, 101, GLENDALE, CA 91205
(818) 265-2260
(818) 265-2268
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A81027
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A810270
—
CA
Enumeration date
07/11/2006
Last updated
10/04/2007
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