Individual
DR. SHAHIN DERBOGHOSSIANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116 S LOUISE ST, GLENDALE, CA 91205
(818) 507-4340
(818) 507-4308
Mailing address
116 S LOUISE ST, GLENDALE, CA 91205-1025
(818) 507-4340
(818) 507-4308
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A42661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A426610
—
CA
Enumeration date
06/28/2006
Last updated
01/17/2022
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