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General NPI Number Information
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NPI Number | 1134638539
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Entity Type | Individual
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Provider Name | ARTUR VARDANYAN ATC
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Gender | Male
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 20644 SAN JOSE ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-2458
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Country | US
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Telephone | 818-653-0782
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Fax |
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Provider Business Mailing Address
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Address Line | 20644 SAN JOSE ST
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City | CHATSWORTH
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State | CA
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Zip | 91311-2458
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Country | US
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Telephone | 818-653-0782
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Fax |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000037984
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License Number State | CA
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