1629133236 NPI number — NOUNE PASHINIAN MD A PROFESSIONAL CORPORATION

Table of content: (NPI 1629133236)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629133236 NPI number — NOUNE PASHINIAN MD A PROFESSIONAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOUNE PASHINIAN MD A PROFESSIONAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
VERDUGO RHEUMATOLOGY MEDICAL GROUP
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629133236
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
435 ARDEN AVE
Provider Second Line Business Mailing Address:
#510
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91203-1137
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-243-1187
Provider Business Mailing Address Fax Number:
818-243-6182

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
435 ARDEN AVE
Provider Second Line Business Practice Location Address:
#510
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91203-1137
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-243-1187
Provider Business Practice Location Address Fax Number:
818-243-6182
Provider Enumeration Date:
12/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PASHINIAN
Authorized Official First Name:
NOUNE
Authorized Official Middle Name:
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
818-243-1187

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X , with the licence number:  A056473 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00A564731 . This is a "MEDICAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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