Healthcare Provider Details

I. General information

NPI: 1548180789
Provider Name (Legal Business Name): MAHSHID REBEKAH GHAZARYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBEKAH GHAZARYAN NP-BC

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 SAN PABLO ST STE 3800
LOS ANGELES CA
90033-5328
US

IV. Provider business mailing address

1520 SAN PABLO ST STE 3800
LOS ANGELES CA
90033-5328
US

V. Phone/Fax

Practice location:
  • Phone: 323-442-7540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF07260966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: