Derboghossians, Shahin
Derboghossians, Shahin is an sole proprietor health care provider with primary practice located at 116 S Louise St , Glendale CA 91205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Derboghossians, Shahin can be contacted via phone (818) 507-4340.Contact Information
Primary practice address
116 S Louise St
Glendale CA 91205
Phone: (818) 507-4340
Fax: (818) 507-4308
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | A42661 | California |
Profile Details
| NPI number | 1710915038 |
|---|---|
| LBN Legal business name | Derboghossians, Shahin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Jan 17th, 2022 - about 2 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 | 1710915038 | NPPES |
| California | MEDICAID | 00A426610 |
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