Provider Demographics
NPI:1427271287
Name:BABASOLOUKIAN, YPROUHI
Entity type:Individual
Prefix:
First Name:YPROUHI
Middle Name:
Last Name:BABASOLOUKIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:523 SOUTH ATLANTIC BL
Mailing Address - Street 2:STE A
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-3865
Mailing Address - Country:US
Mailing Address - Phone:626-284-0223
Mailing Address - Fax:626-284-0243
Practice Address - Street 1:523 SOUTH ATLANTIC BL
Practice Address - Street 2:STE A
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-3865
Practice Address - Country:US
Practice Address - Phone:626-284-0223
Practice Address - Fax:626-284-0243
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32484332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies