Healthcare Provider Details

I. General information

NPI: 1851561807
Provider Name (Legal Business Name): KARMEN SERGEI TATULIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KARMEN SERGEI VARTANIAN M.D.

II. Dates (important events)

Enumeration Date: 03/06/2008
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8902 WOODMAN AVE
ARLETA CA
91331-6401
US

IV. Provider business mailing address

8902 WOODMAN AVENUE EL PROYECTO DEL BARRIO, INC.
ARLETA CA
91331
US

V. Phone/Fax

Practice location:
  • Phone: 818-830-7033
  • Fax:
Mailing address:
  • Phone: 818-830-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA 101992
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: