Healthcare Provider Details

I. General information

NPI: 1851698971
Provider Name (Legal Business Name): LEAH D PAPAZIAN RD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11165 SEPULVEDA BLVD
MISSION HILLS CA
91345-1113
US

IV. Provider business mailing address

PO BOX 9602
MISSION HILLS CA
91346-9602
US

V. Phone/Fax

Practice location:
  • Phone: 818-837-5503
  • Fax: 818-837-5812
Mailing address:
  • Phone: 818-837-5692
  • Fax: 818-792-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number977824
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: