Healthcare Provider Details

I. General information

NPI: 1851034565
Provider Name (Legal Business Name): LARA PARSEKHIAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 E BROADWAY
GLENDALE CA
91205-1110
US

IV. Provider business mailing address

519 E BROADWAY
GLENDALE CA
91205-1110
US

V. Phone/Fax

Practice location:
  • Phone: 818-409-3020
  • Fax:
Mailing address:
  • Phone: 818-409-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21627
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: