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DIANE BAGATOURIAN

>> Organized Health Care Education/Training Program >> Student

Registrant NPI Number: 1891967394

Individual Registrant:
 DIANE  BAGATOURIAN 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
5762 RAVENSPUR DR #414 RANCHO PALOS VERDES, CA 90275-3570 US
Tel: 310-344-1550  Fax: 310-715-1295

Contact information for business:
5762 RAVENSPUR DR #414 RANCHO PALOS VERDES, CA 90275-3570 US
Tel: 310-344-1550  Fax: 310-715-1295

Registration Information:
NPI: 1891967394
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y390200000XStudent
Organized Health Care Education/Training Program

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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