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General NPI Number Information
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NPI Number | 1396337507
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Entity Type | Individual
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Provider Name | AZA BOYAJYAN
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Gender | Female
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Dates
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Enumeration Date | 02/09/2021
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 6606 HAZELTINE AVE APT 106
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City | VAN NUYS
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State | CA
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Zip | 91405-5353
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Country | US
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Telephone | 818-454-2556
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Fax |
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Provider Business Mailing Address
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Address Line | 8473 OSO AVE
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City | WINNETKA
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State | CA
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Zip | 91306-1353
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Country | US
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Telephone |
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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 | 246R00000X
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Taxonomy Name | Pathology Technician
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License Number | 66334
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License Number State | CA
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