Healthcare Provider Details

I. General information

NPI: 1639083280
Provider Name (Legal Business Name): VARTOUK CHAKARDJIAN LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 MILFORD ST
GLENDALE CA
91203-1609
US

IV. Provider business mailing address

509 MILFORD ST
GLENDALE CA
91203-1609
US

V. Phone/Fax

Practice location:
  • Phone: 818-437-2211
  • Fax: 818-437-2211
Mailing address:
  • Phone: 818-437-2211
  • Fax: 818-437-2211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number730941
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: