Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G076663 | CA |
N | 208600000X | Surgeon | G076663 | CA |
N | 208200000X | Surgeon | G076663 | CA |
N | 208600000X | Surgeon | G076663 | CA |
N | 2086S0122X | Plastic and Reconstructive Surgery | G076663 | CA |
NPI | 1013053438 |
---|---|
Provider Name | Dr. Garo Kassabian |
First Address | Beverly Hills, CA 90210-4310 |
Second Address | Beverly Hills, CA 90210-4310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |