Healthcare Provider Details

I. General information

NPI: 1447136452
Provider Name (Legal Business Name): DR. A AIRAPETIAN MD PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2667 N MOORPARK RD STE 108B
THOUSAND OAKS CA
91360-3001
US

IV. Provider business mailing address

6710 N 47TH AVE
GLENDALE AZ
85301-4121
US

V. Phone/Fax

Practice location:
  • Phone: 833-224-5538
  • Fax: 833-424-5538
Mailing address:
  • Phone: 833-224-5538
  • Fax: 833-424-5538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY CORONADO
Title or Position: OFFICE MANAGER
Credential:
Phone: 623-521-9113