Healthcare Provider Details

I. General information

NPI: 1174544001
Provider Name (Legal Business Name): ZAREH HAIGAZOUN VARTIVARIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 WOODLAKE AVE SUITE 220
WEST HILLS CA
91307-1468
US

IV. Provider business mailing address

7320 WOODLAKE AVE SUITE 220
WEST HILLS CA
91307-1468
US

V. Phone/Fax

Practice location:
  • Phone: 818-883-8477
  • Fax: 818-883-2223
Mailing address:
  • Phone: 818-883-8477
  • Fax: 818-883-2223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberC40219
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: