Provider Demographics
NPI:1386031144
Name:SADORIAN, PETER NAZARETH (LAC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:NAZARETH
Last Name:SADORIAN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 DELAWARE ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-4116
Mailing Address - Country:US
Mailing Address - Phone:323-236-5553
Mailing Address - Fax:
Practice Address - Street 1:17672 BEACH BLVD STE E
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6836
Practice Address - Country:US
Practice Address - Phone:323-236-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16527171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist