Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 20A17265 | CA |
NPI | 1023420866 |
---|---|
Provider Name | Armen Oganesian |
First Address | Thousand Oaks, CA 91360-8208 |
Second Address | Thousand Oaks, CA 91360-8208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2014 |
Last Update Date | 01/09/2020 |