Organization
AIRE MEDICAL OF GLENDALE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRIKOR H MANOUKIAN MD (MEDICAL DIRECTOR)
(818) 427-4619
Entity
Organization
Contact information
Practice address
1808 VERDUGO BLVD STE 116, GLENDALE, CA 91208-1455
(000) 000-0000
Mailing address
1808 VERDUGO BLVD STE 116, GLENDALE, CA 91208-1455
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207KA0200X
Allergy Physician
Primary
—
—
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
—
Other
Enumeration date
04/16/2020
Last updated
06/18/2020
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