Healthcare Provider Details

I. General information

NPI: 1457148868
Provider Name (Legal Business Name): NATIONWIDE IOP CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 CANADA BLVD
GLENDALE CA
91208-2837
US

IV. Provider business mailing address

1544 CANADA BLVD
GLENDALE CA
91208-2837
US

V. Phone/Fax

Practice location:
  • Phone: 272-222-0002
  • Fax:
Mailing address:
  • Phone: 272-222-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ARMEN HARUTYUNYAN
Title or Position: CEO
Credential:
Phone: 272-222-0002