Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E4971 | CA |
NPI | 1043589211 |
---|---|
Provider Name | Gregory Arkadievich Tovmassian |
First Address | Carmichael, CA 95608-0590 |
Second Address | Fair Oaks, CA 95628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2011 |
Last Update Date | 27/08/2018 |