=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497655211
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAFFI CHALIAN MD A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2026
-----------------------------------------------------
Last Update Date | 11/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1505 WILSON TER STE 150
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91206-4076
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 626-351-5125
-----------------------------------------------------
Fax | 917-456-0485
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 11719 STE 125
-----------------------------------------------------
City | BURBANK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91510-1719
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-504-7265
-----------------------------------------------------
Fax | 818-504-7203
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MARY OUNDJIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-504-7265
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207VX0201X
-----------------------------------------------------
Taxonomy Name | Gynecologic Oncology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------