Individual
DESPINA GHABY KAYICHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8636
(310) 392-7875
Mailing address
1500 S CENTRAL AVE, SUITE #221, GLENDALE, CA 91204-2530
(818) 500-4055
(818) 500-4065
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A52950
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A529500
—
CA
Enumeration date
08/31/2006
Last updated
03/31/2021
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