MEDICARE: MRS. NOVART OGHAMIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235160151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NOVART OGHAMIAN

Provider Business Mailing Address
First Line	:	1018 E BROADWAY
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1206
Country	:	US
Telephone Number	:	818-507-7070
Fax Number	:	818-507-6687

Provider Business Practice Location Address
First Line	:	1018 E BROADWAY
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1206
Country	:	US
Telephone Number	:	818-507-7070
Fax Number	:	818-507-6687

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	09/14/2010

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