Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC21112 | CA |
NPI | 1053348714 |
---|---|
Provider Name | Dr. Hrayr M. Sassounian |
First Address | Glendale, CA 91209-3309 |
Second Address | Glendale, CA 91203-1129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 07/03/2013 |