Healthcare Provider Details

I. General information

NPI: 1639106230
Provider Name (Legal Business Name): VIGEN ZARGARIAN M.D., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 09/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2048 MONTROSE AVE
MONTROSE CA
91020-1605
US

IV. Provider business mailing address

2048 MONTROSE AVE
MONTROSE CA
91020-1605
US

V. Phone/Fax

Practice location:
  • Phone: 818-957-2224
  • Fax: 818-957-2261
Mailing address:
  • Phone: 818-957-2224
  • Fax: 818-957-2261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA671070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: