Provider Demographics
NPI:1174899587
Name:RAZMIG KRUMIAN D.O. A MEDICAL CORPORATION
Entity type:Organization
Organization Name:RAZMIG KRUMIAN D.O. A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAZMIG
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUMIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-889-9230
Mailing Address - Street 1:32144 AGOURA RD
Mailing Address - Street 2:SUITE 218
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4031
Mailing Address - Country:US
Mailing Address - Phone:818-889-9230
Mailing Address - Fax:818-889-9235
Practice Address - Street 1:32144 AGOURA RD
Practice Address - Street 2:SUITE 218
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-4031
Practice Address - Country:US
Practice Address - Phone:818-889-9230
Practice Address - Fax:818-889-9235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-29
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8716208D00000X
CA20A7776207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty