Organization
AXIOGRAFT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANVEL KONDRADZHYAN MD (CEO)
(323) 253-5821
Entity
Organization
Contact information
Practice address
815 S CENTRAL AVE STE 11, GLENDALE, CA 91204-2080
(818) 325-5090
Mailing address
815 S CENTRAL AVE STE 11, GLENDALE, CA 91204-2080
(818) 325-5090
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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