Basic Information
Provider Information
NPI: 1467961359
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KATCHIKIAN
FirstName: HURIG
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5767 W CENTURY BLVD SUITE 400
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900955631
CountryCode: US
TelephoneNumber: 3103018707
FaxNumber: 3103018781
Practice Location
Address1: 25775 MCBEAN PKWY STE 215
Address2:  
City: VALENCIA
State: CA
PostalCode: 913553703
CountryCode: US
TelephoneNumber: 6617535464
FaxNumber: 6617535466
Other Information
ProviderEnumerationDate: 09/24/2017
LastUpdateDate: 04/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XA165416CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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