Healthcare Provider Details

I. General information

NPI: 1265488845
Provider Name (Legal Business Name): RAZMIK OHANJANIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 09/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 WESTERN AVE
GLENDALE CA
91201-2870
US

IV. Provider business mailing address

511 WESTERN AVE
GLENDALE CA
91201-2870
US

V. Phone/Fax

Practice location:
  • Phone: 818-240-5588
  • Fax: 818-240-3148
Mailing address:
  • Phone: 818-240-5588
  • Fax: 818-240-3148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA52219
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: