Healthcare Provider Details

I. General information

NPI: 1033087051
Provider Name (Legal Business Name): LIANA GHAZARYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 W RIVERSIDE DR STE 402
BURBANK CA
91505-5301
US

IV. Provider business mailing address

5555 GARDEN GROVE BLVD STE 200
WESTMINSTER CA
92683-8234
US

V. Phone/Fax

Practice location:
  • Phone: 818-842-4069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number4115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: