Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 95014777 | CA |
NPI | 1003433236 |
---|---|
Provider Name | Ms. Gayane Celine Babakhanian |
First Address | Tujunga, CA 91042-1718 |
Second Address | Tujunga, CA 91042-1718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2020 |
Last Update Date | 10/07/2020 |