Healthcare Provider Details

I. General information

NPI: 1841305562
Provider Name (Legal Business Name): ARUTYUN TOVANYAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11650 RIVERSIDE DR STE 6
NORTH HOLLYWOOD CA
91602-1066
US

IV. Provider business mailing address

11650 RIVERSIDE DR STE 6
NORTH HOLLYWOOD CA
91602-1066
US

V. Phone/Fax

Practice location:
  • Phone: 818-980-1221
  • Fax: 818-980-3221
Mailing address:
  • Phone: 818-980-1221
  • Fax: 818-980-3221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC29828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: