Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | A81347 | CA |
NPI | 1154538213 |
---|---|
Provider Name | Dr. Andre Aboolian |
First Address | Glendale, CA 91202-2506 |
Second Address | Beverly Hills, CA 90212-1840 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 22/08/2008 |