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NPI Code Detail

MEDICARE: ALEN MIRZAIAN, MD INC

MEDICARE: ALEN MIRZAIAN, MD INC
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
1207R00000XInternal Medicine PhysicianA88445CA

General Provider Information

NPI Number : 1255669362
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALEN MIRZAIAN, MD INC
Provider Business Mailing Address
First Line : 2155 VERDUGO BLVD # 24
Second Line :
City : MONTROSE
State : CA
Zip : 91020-1628
Country : US
Telephone Number : 818-790-1145
Fax Number : 818-790-6387
Provider Business Practice Location Address
First Line : 1818 VERDUGO BLVD STE 401
Second Line :
City : GLENDALE
State : CA
Zip : 91208-1421
Country : US
Telephone Number : 818-790-1145
Fax Number : 818-790-6387
Authorized Official
Title or Position : MD/PRESIDENT
Name : ALEN MIRZAIAN
Credential : MD
Telephone Number : 818-790-1145
Provider Enumeration Date : 12/01/2009
Last Update Date : 06/06/2023

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Practice Location Address:
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Practice Phone: 818-790-1145
Practice Fax: 818-790-6387

Directions to “ALEN MIRZAIAN, MD INC ” Practice Location

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