=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801608294
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALEX NOURIAN M.D., INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2025
-----------------------------------------------------
Last Update Date | 08/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1808 VERDUGO BLVD STE 110
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91208-1450
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-242-1932
-----------------------------------------------------
Fax | 818-242-9462
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2273 STRATFORD CIR
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90077-1316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-213-9168
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ALEX AARON NOURIAN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 310-213-9168
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------