Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | A49429 | CA |
NPI | 1417974478 |
---|---|
Provider Name | Dr. Harout Raffi Balian |
First Address | Pasadena, CA 91106-1570 |
Second Address | Pasadena, CA 91106-1570 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 08/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A494291 | (05) | CA |
00A494293 | (05) | CA |
F56434 | (02) |