Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 54750 | CA |
NPI | 1003041302 |
---|---|
Provider Name | Dr. Artin Manoukian |
First Address | Glendale, CA 91221-0151 |
Second Address | Montrose, CA 91020-1817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2009 |
Last Update Date | 30/01/2014 |