Davtyan, Hakob Grigor

Davtyan, Hakob Grigor is an individual health care provider with primary practice located at 401 E Highland Ave Suite 251, San Bernardino CA 92404-3803. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery). Other Service Providers / Specialist is his primary health care specialty. Davtyan, Hakob Grigor can be contacted via phone (909) 881-1614.

Contact Information

Primary practice address
401 E Highland Ave Suite 251 San Bernardino CA 92404-3803
Phone: (909) 881-1614
Fax: (909) 881-2711
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G54367 California
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 031902 Georgia

Profile Details

NPI number 1437180676
LBN Legal business name Davtyan, Hakob Grigor
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Jul 12th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437180676 NPPES
Georgia Other 031902 LICENSE
Georgia MEDICAID 00G543670 LICENSE
Georgia Other G54367 LICENSE
Georgia Other 00G543671 LICENSE
Georgia Other ZZZ07161Z LICENSE

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