Provider Demographics
NPI:1043726367
Name:PERCH YETENIKYAN, INC.
Entity type:Organization
Organization Name:PERCH YETENIKYAN, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PERCH
Authorized Official - Middle Name:
Authorized Official - Last Name:YETENIKYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-467-7770
Mailing Address - Street 1:5465 SANTA MONICA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-2339
Mailing Address - Country:US
Mailing Address - Phone:323-467-7770
Mailing Address - Fax:323-467-4544
Practice Address - Street 1:5465 SANTA MONICA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2339
Practice Address - Country:US
Practice Address - Phone:323-467-7770
Practice Address - Fax:323-467-4544
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PERCH YETENIKYAN, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-12-22
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty