Organization
MEDICAL CLINIC AND SURGICAL SPECIALTIES OF GLENDALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARDIROS HAIG MIHRANIAN MD (PRESIDENT SECRETARY)
(818) 240-1820
Entity
Organization
Contact information
Practice address
1510 S CENTRAL AVE, #100, GLENDALE, CA 91204-2582
(818) 240-1820
(818) 240-1021
Mailing address
1510 S CENTRAL AVE, #100, GLENDALE, CA 91204-2582
(818) 240-1820
(818) 240-1021
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A30059
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A300590
—
CA
Enumeration date
02/01/2007
Last updated
08/22/2020
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