Healthcare Provider Details

I. General information

NPI: 1336057033
Provider Name (Legal Business Name): ANAHIT N. KHALAFYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 NEWBY ST
GLENDALE CA
91201-2207
US

IV. Provider business mailing address

230 N MARYLAND AVE STE 209
GLENDALE CA
91206-4282
US

V. Phone/Fax

Practice location:
  • Phone: 413-848-8888
  • Fax:
Mailing address:
  • Phone: 413-848-8888
  • Fax: 747-215-6892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: