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General NPI Number Information
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NPI Number | 1124267653
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Entity Type | Individual
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Provider Name | KARINE SARGSYAN
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Gender | Female
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 02/05/2009
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Provider Practice Location Address
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Address Line | 221 W ELM AVE APT S S
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City | BURBANK
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State | CA
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Zip | 91502-3035
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Country | US
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Telephone | 818-823-6717
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Fax | 310-691-8877
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Provider Business Mailing Address
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Address Line | 221 W ELM AVE APT S S
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City | BURBANK
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State | CA
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Zip | 91502-3035
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Country | US
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Telephone | 818-823-6717
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Fax | 310-691-8877
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | B4174885
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number | A4680527
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License Number State | CA
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