Healthcare Provider Details

I. General information

NPI: 1174823363
Provider Name (Legal Business Name): VAHE BADALIAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 E CHEVY CHASE DR STE 201
GLENDALE CA
91206-4139
US

IV. Provider business mailing address

1530 E CHEVY CHASE DR STE 201
GLENDALE CA
91206-4139
US

V. Phone/Fax

Practice location:
  • Phone: 818-247-9200
  • Fax: 818-484-8190
Mailing address:
  • Phone: 818-247-9200
  • Fax: 818-484-8190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: VAHE BADALIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-247-9200