Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | A111311 | CA |
NPI | 1669624219 |
---|---|
Provider Name | Dr. Marine Demirjian |
First Address | Glendale, CA 91202-2358 |
Second Address | Glendale, CA 91202 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2008 |
Last Update Date | 20/03/2017 |