Healthcare Provider Details

I. General information

NPI: 1215248406
Provider Name (Legal Business Name): ANGELA ZURABYAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N STATE ST
LOS ANGELES CA
90033-1029
US

IV. Provider business mailing address

2461 WAGNER ST UNIT 2
PASADENA CA
91107-2565
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-5700
  • Fax:
Mailing address:
  • Phone: 626-578-1254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number20A11282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: