Provider Demographics
NPI:1023287489
Name:AGHAIAN, ELSA (MD)
Entity type:Individual
Prefix:
First Name:ELSA
Middle Name:
Last Name:AGHAIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:607 N. CENTRAL AVE.
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1804
Mailing Address - Country:US
Mailing Address - Phone:818-956-1010
Mailing Address - Fax:818-543-6083
Practice Address - Street 1:607 N. CENTRAL AVE.
Practice Address - Street 2:SUITE 204
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1808
Practice Address - Country:US
Practice Address - Phone:818-956-1010
Practice Address - Fax:818-543-6083
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2013-10-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA97896207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1023287489OtherNPI