Healthcare Provider Details

I. General information

NPI: 1679273718
Provider Name (Legal Business Name): MARINA TOVMASIAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2023
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 N CENTRAL AVE
GLENDALE CA
91203-3556
US

IV. Provider business mailing address

12616 LITHUANIA DR
GRANADA HILLS CA
91344-1503
US

V. Phone/Fax

Practice location:
  • Phone: 818-246-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF01230142
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: