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1114110632
SHANT BOSHNAKIAN
NORTHRIDGE, CA
NPI
1114110632
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA PA 17078)
Enumeration Date
2007-08-20
Last Update Date
2007-08-20
Business Address
-- SHANT BOSHNAKIAN PA
18300 ROSCOE BLVD
NORTHRIDGE, CA 91325-4105
Phone number: 818-885-8500
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Mailing Address
-- SHANT BOSHNAKIAN PA
PO BOX 12410
WESTMINSTER, CA 92685-2410
Phone number: 866-234-5107
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