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General NPI Number Information
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NPI Number | 1184772048
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Entity Type | Individual
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Provider Name | FLORA ABRAHAMIAN VARDANIAN MD
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Gender | Female
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 03/12/2019
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Provider Practice Location Address
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Address Line | 94 N MADISON AVE
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City | PASADENA
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State | CA
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Zip | 91101-1740
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Country | US
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Telephone | 626-792-4171
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Fax | 626-792-2328
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Provider Business Mailing Address
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Address Line | 94 N MADISON AVE
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City | PASADENA
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State | CA
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Zip | 91101-1740
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Country | US
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Telephone | 626-792-4171
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Fax | 626-792-2328
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 261242
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A85631
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | A85631
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License Number State | CA
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