Basic Information
| Provider Information | |||||||||
| NPI: | 1285036640 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAJIAN | ||||||||
| FirstName: | PETROS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10752 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912093752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185572671 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 191 S BUENA VISTA ST | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | BURBANK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 915054554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8185572671 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2014 | ||||||||
| LastUpdateDate: | 07/18/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20A13557 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.