Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC14694 | CA |
NPI | 1659511897 |
---|---|
Provider Name | Dr. Sarkis Mesrobian |
First Address | Glendale, CA 91205-1200 |
Second Address | Glendale, CA 91205-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2009 |
Last Update Date | 28/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DC14694 | (02) | CA |