Individual
DR. ANNIE KUPELIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3811 VALLEY CENTRE DR, SAN DIEGO, CA 92130-3318
(858) 764-3030
Mailing address
54433 FILE, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G69748
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G697480
—
CA
01
—
110169527
RAILROAD MEDICARE
—
01
—
A025
CHAMPUS
—
01
—
F624
CHAMPUS
—
Enumeration date
09/16/2006
Last updated
06/26/2009
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