Individual
DR. DANIEL KULLUKIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., SA-C
Contact information
Practice address
4626 E. SHEENA DR., PHOENIX, AZ 85032
(602) 295-8370
Mailing address
4626 E SHEENA DR, PHOENIX, AZ 85032-5524
(602) 295-8370
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17193
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609119304
—
AZ
Enumeration date
04/01/2013
Last updated
03/29/2017
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