Healthcare Provider Details

I. General information

NPI: 1801663364
Provider Name (Legal Business Name): GAYANE N A ARUTUNIAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 E SIERRA MADRE BLVD
PASADENA CA
91107-1948
US

IV. Provider business mailing address

3825 DENAIR ST
PASADENA CA
91107-1306
US

V. Phone/Fax

Practice location:
  • Phone: 626-510-6677
  • Fax: 626-510-6766
Mailing address:
  • Phone: 818-913-0256
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06231615
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: