Individual
JOHN MGRDITCH DEIRMENJIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 W BROADWAY, SUITE 201, LONG BEACH, CA 90802-4437
(310) 428-3234
(562) 901-0501
Mailing address
333 W. BROADWAY, SUITE 201, LONG BEACH, CA 90802
(310) 428-3234
(562) 901-0501
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G77009
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G770090
—
CA
Enumeration date
08/11/2006
Last updated
01/28/2011
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