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General NPI Number Information
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NPI Number | 1750627196
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Entity Type | Individual
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Provider Name | TANDIK EVAZYAN MD
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Gender | Female
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 12/02/2021
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Provider Practice Location Address
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Address Line | 1520 SAN PABLO ST SUITE 3450
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City | LOS ANGELES
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State | CA
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Zip | 90033-5310
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Country | US
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Telephone | 323-442-6202
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Fax |
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Provider Business Mailing Address
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Address Line | 601 E DEL MAR BLVD APT 406
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City | PASADENA
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State | CA
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Zip | 91101-2826
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Country | US
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Telephone | 818-515-2411
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A111262
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License Number State | CA
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