Basic Information
| Provider Information | |||||||||
| NPI: | 1952533960 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABRAHAMIAN | ||||||||
| FirstName: | HAROUTUN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1441 HIGHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 912021405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8183174767 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4316 SLAUSON AVE | ||||||||
| Address2: | |||||||||
| City: | MAYWOOD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902702838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237719867 | ||||||||
| FaxNumber: | 3237716094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2009 | ||||||||
| LastUpdateDate: | 12/07/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | A112196 | CA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | P01869461 | 01 | CA | RAILROAD | OTHER | CB277988 | 01 | CA | MEDICARE | OTHER | 2320644 | 01 | CA | CIGNA | OTHER | CA266397 | 01 | CA | MEDICARE | OTHER | CA266421 | 01 | CA | MEDICARE | OTHER |