Healthcare Provider Details

I. General information

NPI: 1992773253
Provider Name (Legal Business Name): ARBI GHAZARIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 MONTROSE AVE SUITE E
MONTROSE CA
91020-1546
US

IV. Provider business mailing address

2103 MONTROSE AVE SUITE E
MONTROSE CA
91020-1546
US

V. Phone/Fax

Practice location:
  • Phone: 818-957-2007
  • Fax: 818-957-3929
Mailing address:
  • Phone: 818-957-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA81408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: