Organization
LEVON ANTOSSYAN INC
Active
Organization
LEVON ANTOSSYAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEVON ANTOSSYAN M.D. (OWENER PHYSICIAN)
(818) 551-0001
Entity
Organization
Contact information
Practice address
1204 S CENTRAL AVE, GLENDALE, CA 91204-2504
(818) 551-0001
Mailing address
1204 S CENTRAL AVE, GLENDALE, CA 91204-2504
(818) 551-0001
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
A053324
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A533241
—
CA
Enumeration date
05/12/2006
Last updated
12/20/2009
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