Healthcare Provider Details

I. General information

NPI: 1144970351
Provider Name (Legal Business Name): EDWARD ANTRANIK MEZIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLZ STE 3325
LOS ANGELES CA
90095-7419
US

IV. Provider business mailing address

5767 W CENTURY BLVD # 400
LOS ANGELES CA
90045-5631
US

V. Phone/Fax

Practice location:
  • Phone: 310-267-8655
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA189286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: