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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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