Healthcare Provider Details

I. General information

NPI: 1508191214
Provider Name (Legal Business Name): KAREN NERSISSIAN ZAGHIYAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8737 BEVERLY BLVD #101
LOS ANGELES CA
90048
US

IV. Provider business mailing address

8737 BEVERLY BLVD #101
LOS ANGELES CA
90048
US

V. Phone/Fax

Practice location:
  • Phone: 310-289-9224
  • Fax: 310-289-8995
Mailing address:
  • Phone: 310-289-9224
  • Fax: 310-289-8995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA108443
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: