Healthcare Provider Details

I. General information

NPI: 1497781603
Provider Name (Legal Business Name): MARINA G BARSUMIAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 CENTURY PARK E
LOS ANGELES CA
90067-2009
US

IV. Provider business mailing address

11928 DUNNICLIFFE CT
NORTHRIDGE CA
91326-1324
US

V. Phone/Fax

Practice location:
  • Phone: 909-946-5752
  • Fax: 909-985-3858
Mailing address:
  • Phone: 818-360-5653
  • Fax: 909-985-3858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA417
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: