Healthcare Provider Details

I. General information

NPI: 1407770126
Provider Name (Legal Business Name): DAVIT PETROSYAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17029 CHATSWORTH ST STE 100
GRANADA HILLS CA
91344-7801
US

IV. Provider business mailing address

464 W LEXINGTON DR APT 2
GLENDALE CA
91203-2714
US

V. Phone/Fax

Practice location:
  • Phone: 818-407-0007
  • Fax:
Mailing address:
  • Phone: 818-930-0314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number37713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: