Healthcare Provider Details

I. General information

NPI: 1437022167
Provider Name (Legal Business Name): RIPSIME MKRTCHIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 ETHEL AVE
VAN NUYS CA
91401-2523
US

IV. Provider business mailing address

6340 ETHEL AVE
VAN NUYS CA
91401-2523
US

V. Phone/Fax

Practice location:
  • Phone: 323-633-9493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95037230
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: