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General NPI Number Information
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NPI Number | 1437384914
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Entity Type | Organization
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Legal Business Name | YERVAND DARVEN SET-AGAYAN DO PC
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Dates
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Enumeration Date | 05/27/2009
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 800 S CENTRAL AVE UNIT # 306
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City | GLENDALE
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State | CA
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Zip | 91204-4370
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Country | US
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Telephone | 818-383-6789
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Fax | 818-242-4022
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Provider Business Mailing Address
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Address Line | 800 S CENTRAL AVE UNIT # 306
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City | GLENDALE
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State | CA
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Zip | 91204-4370
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Country | US
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Telephone | 818-383-6789
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Fax | 818-242-4022
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YERVAND WILLIAM SET-AGAYAN
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Credential | DO
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Telephone | 818-383-6789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A9932
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License Number State | CA
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