Rostomian, Souren A
Rostomian, Souren A is an individual health care provider with primary practice located at 6300 San Fernando Rd , Glendale CA 91201-2414. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Rostomian, Souren A can be contacted via phone (818) 547-4455.Contact Information
Primary practice address
6300 San Fernando Rd
Glendale CA 91201-2414
Phone: (818) 547-4455
Fax: (818) 547-9955
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 44534 | California |
Profile Details
| NPI number | 1184771818 |
|---|---|
| LBN Legal business name | Rostomian, Souren A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 4th, 2007 |
| Last updated | Apr 5th, 2017 - about 8 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 | 1184771818 | NPPES |
| California | MEDICAID | G9307801 |
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