Provider Demographics
NPI:1962793695
Name:RL DOYAN MD, INC
Entity type:Organization
Organization Name:RL DOYAN MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:8182-445-4444
Mailing Address - Street 1:1241 S GLENDALE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-3385
Mailing Address - Country:US
Mailing Address - Phone:818-244-5444
Mailing Address - Fax:818-243-0193
Practice Address - Street 1:1030 S GLENDALE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-5612
Practice Address - Country:US
Practice Address - Phone:818-244-5444
Practice Address - Fax:818-243-0193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50937207R00000X
2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty