Healthcare Provider Details

I. General information

NPI: 1124086830
Provider Name (Legal Business Name): MR. AKOP AYRANDZHYAN
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N BRAND BLVD 825
GLENDALE CA
91203-4427
US

IV. Provider business mailing address

401 N BRAND BLVD 825
GLENDALE CA
91203-4427
US

V. Phone/Fax

Practice location:
  • Phone: 818-243-2501
  • Fax:
Mailing address:
  • Phone: 818-243-2501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: