MEDICARE: SAMVEL HMAYAKYAN M.D.

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	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	A66625	CA
2	207Q00000X	Family Medicine Physician	A66625	CA

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	:	1538168174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMVEL HMAYAKYAN M.D.

Provider Business Mailing Address
First Line	:	1133 S CENTRAL AVE UNIT 1
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2212
Country	:	US
Telephone Number	:	818-244-0400
Fax Number	:	818-244-2836

Provider Business Practice Location Address
First Line	:	1133 S CENTRAL AVE UNIT 1
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91204-2212
Country	:	US
Telephone Number	:	818-244-0400
Fax Number	:	818-244-2836

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	03/07/2023

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