Individual
RITA DERKALOUSDIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1808 VERDUGO BLVD STE 120, GLENDALE, CA 91208-1447
(818) 952-1124
Mailing address
3622 VIRGINIA ST, GLENDALE, CA 91214-1745
(818) 667-3902
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
42885
CA
Other
Enumeration date
12/23/2024
Last updated
12/23/2024
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