Healthcare Provider Details

I. General information

NPI: 1730708413
Provider Name (Legal Business Name): ARTYOM KHURSHUDYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

IV. Provider business mailing address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

V. Phone/Fax

Practice location:
  • Phone: 818-869-7639
  • Fax:
Mailing address:
  • Phone: 818-869-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA190575
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: