Provider Demographics
NPI:1942099320
Name:TIGRAN KHACHATRYAN, M.D. INC
Entity type:Organization
Organization Name:TIGRAN KHACHATRYAN, M.D. INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIGRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHATRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-305-9904
Mailing Address - Street 1:1505 WILSON TER STE 150
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4076
Mailing Address - Country:US
Mailing Address - Phone:380-888-1818
Mailing Address - Fax:380-888-1818
Practice Address - Street 1:1505 WILSON TER STE 150
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4076
Practice Address - Country:US
Practice Address - Phone:380-888-1818
Practice Address - Fax:380-888-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-02
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty