Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 18984 | CA |
NPI | 1366634453 |
---|---|
Provider Name | Dr. Garbis Tsitsinian |
First Address | Glendale, CA 91204-4343 |
Second Address | Glendale, CA 91204-4343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2007 |
Last Update Date | 13/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B50866 | (02) | CA |