Healthcare Provider Details

I. General information

NPI: 1548849631
Provider Name (Legal Business Name): ARMINE AVAKIAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 04/06/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E COLORADO ST STE 420
GLENDALE CA
91205-5123
US

IV. Provider business mailing address

2031 BUCKINGHAM PL
GLENDALE CA
91206-1402
US

V. Phone/Fax

Practice location:
  • Phone: 818-502-1341
  • Fax:
Mailing address:
  • Phone: 310-614-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95015748
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: