Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | A122745 | CA |
NPI | 1184670408 |
---|---|
Provider Name | Raffi A Chalian |
First Address | Newport Beach, CA 92663-3500 |
Second Address | Glendale, CA 91206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 15/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0123129 | (05) | NJ |
101834663 | (05) | PA |