Healthcare Provider Details

I. General information

NPI: 1760281307
Provider Name (Legal Business Name): SAMUEL KARO DUZARYAN D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 E COLORADO ST STE 250
GLENDALE CA
91205-4510
US

IV. Provider business mailing address

11611 TAMPA AVE UNIT 189
PORTER RANCH CA
91326-1468
US

V. Phone/Fax

Practice location:
  • Phone: 818-523-6661
  • Fax: 818-246-3604
Mailing address:
  • Phone: 818-523-6661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number37201
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: