Healthcare Provider Details

I. General information

NPI: 1568468650
Provider Name (Legal Business Name): KEVORK ARTIN VORPERIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 11/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8134 FOOTHILL BLVD
SUNLAND CA
91040-2941
US

IV. Provider business mailing address

519 E BROADWAY
GLENDALE CA
91205-1110
US

V. Phone/Fax

Practice location:
  • Phone: 818-962-0715
  • Fax: 818-962-0714
Mailing address:
  • Phone: 818-409-3020
  • Fax: 818-243-2713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC50258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: