MEDICARE: DR. ARMINE NAZARYAN 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	207Q00000X	Family Medicine Physician	A 85687	CA

General Provider Information

NPI Number	:	1972505444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARMINE NAZARYAN M.D.

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	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2005
Last Update Date	:	07/28/2009

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