Organization
SHAHIN DERBOGHOSSIANS MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHIN DERBOGHOSSIANS MD (MD)
(818) 507-4340
Entity
Organization
Contact information
Practice address
1030 S GLENDALE, 301, GLENDALE, CA 91205
(818) 507-4340
(818) 507-4348
Mailing address
1030 S GLENDALE, 301, GLENDALE, CA 91205
(818) 507-4340
(818) 507-4348
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
A42661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A426610
—
CA
01
—
A42661
MEDICAL LICENSE
—
Enumeration date
10/18/2010
Last updated
10/18/2010
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