Provider Demographics
NPI:1447726849
Name:EDVIN DILANCHIYAN MD INC
Entity type:Organization
Organization Name:EDVIN DILANCHIYAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DILANCHIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-823-0347
Mailing Address - Street 1:1934 CALLE SIRENA
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-3033
Mailing Address - Country:US
Mailing Address - Phone:818-823-0347
Mailing Address - Fax:
Practice Address - Street 1:1509 WILSON TER
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4007
Practice Address - Country:US
Practice Address - Phone:818-823-0347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty