Healthcare Provider Details

I. General information

NPI: 1376401034
Provider Name (Legal Business Name): MD ON THE GO MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 S CENTRAL AVE STE 1B
GLENDALE CA
91204-2046
US

IV. Provider business mailing address

815 S CENTRAL AVE STE 1B
GLENDALE CA
91204-2046
US

V. Phone/Fax

Practice location:
  • Phone: 747-900-9700
  • Fax:
Mailing address:
  • Phone: 747-900-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. ANNETTE ASHKEN ZARGARYAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 818-601-6666