Healthcare Provider Details

I. General information

NPI: 1497655211
Provider Name (Legal Business Name): RAFFI CHALIAN MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 10/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 WILSON TER STE 150
GLENDALE CA
91206-4076
US

IV. Provider business mailing address

PO BOX 11719 STE 125
BURBANK CA
91510-1719
US

V. Phone/Fax

Practice location:
  • Phone: 626-351-5125
  • Fax: 917-456-0485
Mailing address:
  • Phone: 818-504-7265
  • Fax: 818-504-7203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARY OUNDJIAN
Title or Position: CEO
Credential:
Phone: 818-504-7265