Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | A38572 | CA |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | A38572 | CA |
NPI | 1750314704 |
---|---|
Provider Name | Dr. Armen Serebrakian |
First Address | Pinole, CA 94564-2519 |
Second Address | Pinole, CA 94564-2519 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 03/07/2019 |