Healthcare Provider Details

I. General information

NPI: 1972268316
Provider Name (Legal Business Name): BLAISE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19350 BUSINESS CENTER DR STE 100
NORTHRIDGE CA
91324-6432
US

IV. Provider business mailing address

19350 BUSINESS CENTER DR STE 100
NORTHRIDGE CA
91324-6432
US

V. Phone/Fax

Practice location:
  • Phone: 818-818-5078
  • Fax: 747-202-0262
Mailing address:
  • Phone: 818-818-5078
  • Fax: 747-202-0262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARTIN ARAYIKOVICH SAHAKYAN
Title or Position: CEO
Credential: MD
Phone: 818-818-5078