MEDICARE: ARMINE NAZARYAN, M.D., MEDICAL CLINIC,INC., A PROFESSIONAL CORPORATION

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	A85687	CA

General Provider Information

NPI Number	:	1689715070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARMINE NAZARYAN, M.D., MEDICAL CLINIC,INC., A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	221 S GLENDALE AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1713
Country	:	US
Telephone Number	:	818-500-0716
Fax Number	:	818-500-0245

Provider Business Practice Location Address
First Line	:	221 S GLENDALE AVE
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91205-1713
Country	:	US
Telephone Number	:	818-500-0716
Fax Number	:	818-500-0245

Authorized Official
Title or Position	:	CEO, CFO
Name	:	DR. ARMINE NAZARYAN
Credential	:	M.D.
Telephone Number	:	818-500-0716

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/28/2009

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