Provider Demographics
NPI:1053348714
Name:SASSOUNIAN, HRAYR M (DC)
Entity type:Individual
Prefix:DR
First Name:HRAYR
Middle Name:M
Last Name:SASSOUNIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10309
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91209-3309
Mailing Address - Country:US
Mailing Address - Phone:818-543-1544
Mailing Address - Fax:818-543-1548
Practice Address - Street 1:372 ARDEN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1129
Practice Address - Country:US
Practice Address - Phone:818-543-1544
Practice Address - Fax:818-543-1548
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC21112111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic