Healthcare Provider Details

I. General information

NPI: 1609719475
Provider Name (Legal Business Name): LILIT GALSTYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 ARDEN AVE
GLENDALE CA
91203-1130
US

IV. Provider business mailing address

8609 REMICK AVE
SUN VALLEY CA
91352-2934
US

V. Phone/Fax

Practice location:
  • Phone: 818-242-3916
  • Fax:
Mailing address:
  • Phone: 818-439-1551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA55410
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: