Individual
MELITA TALENE PETROSSIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1301 20TH ST STE 150, SANTA MONICA, CA 90404-2050
(310) 582-7433
(310) 582-7495
Mailing address
2200 SANTA MONICA BLVD, SUITE 112, SANTA MONICA, CA 90404-2312
(310) 582-7433
(310) 582-7495
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A120954
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790812162
—
CA
Enumeration date
02/27/2007
Last updated
04/19/2021
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