Individual
JACO HAGOP FESTEKJIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLZ, #465, LOS ANGELES, CA 90095-0001
(310) 825-5510
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 825-5510
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
A53799
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A537990
—
CA
Enumeration date
07/28/2006
Last updated
08/13/2010
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