Deravedissian, Harry
Deravedissian, Harry is an sole proprietor health care provider with primary practice located at 1829 S Brand Blvd , Glendale CA 91204-2902. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Deravedissian, Harry can be contacted via phone (818) 543-5900.Contact Information
Primary practice address
1829 S Brand Blvd
Glendale CA 91204-2902
Phone: (818) 543-5900
Fax: (818) 543-5902
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | DC21942 | California |
Profile Details
| NPI number | 1548303803 |
|---|---|
| LBN Legal business name | Deravedissian, Harry |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548303803 | NPPES |
| California | MEDICAID | DC0219420 |
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