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Individual

ANDY MADOYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1737 E WASHINGTON BLVD STE 5, PASADENA, CA 91104-2772
(626) 314-2222
(626) 314-2224
Mailing address
1737 E WASHINGTON BLVD STE 5, PASADENA, CA 91104-2772
(626) 314-2222
(626) 314-2224

Taxonomy

Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
05D2145028
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C6236693
DRIVERS LICENSE
CA
Enumeration date
03/28/2018
Last updated
03/28/2018
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