MEDICARE: DR. ARA AIRAPETIAN MD

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	208D00000X	General Practice Physician	A86421	CA

General Provider Information

NPI Number	:	1578543443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARA AIRAPETIAN MD

Provider Business Mailing Address
First Line	:	801 S CHEVY CHASE DR
Second Line	:	#20
City	:	GLENDALE
State	:	CA
Zip	:	91205-4431
Country	:	US
Telephone Number	:	323-256-4116
Fax Number	:	323-478-9454

Provider Business Practice Location Address
First Line	:	1704 COLORADO BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-1338
Country	:	US
Telephone Number	:	323-256-4116
Fax Number	:	323-478-9454

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	12/13/2012

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