Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | R-10929 | IA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | A169931 | CA |
NPI | 1164952941 |
---|---|
Provider Name | Dr. Martin Arayikovich Sahakyan |
First Address | Rancho Mirage, CA 92270-5511 |
Second Address | Rancho Mirage, CA 92270-5511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2017 |
Last Update Date | 28/10/2021 |