Healthcare Provider Details

I. General information

NPI: 1225219769
Provider Name (Legal Business Name): V NAVASARDIAN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 E WASHINGTON BLVD
PASADENA CA
91104-2657
US

IV. Provider business mailing address

1546 E WASHINGTON BLVD
PASADENA CA
91104-2657
US

V. Phone/Fax

Practice location:
  • Phone: 626-791-2552
  • Fax: 625-791-2506
Mailing address:
  • Phone: 626-791-2552
  • Fax: 625-791-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA69393
License Number StateCA

VIII. Authorized Official

Name: DR. VIOLETA M NAVASARDIAN
Title or Position: CEO
Credential: M.D.
Phone: 626-791-2552