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General NPI Number Information
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NPI Number | 1841693959
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Entity Type | Organization
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Legal Business Name | KARINE TAGMAZYAN MD, MPH, INC
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Dates
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Enumeration Date | 10/02/2014
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Last Update Date | 10/22/2014
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Provider Practice Location Address
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Address Line | 1251 S GLENDALE AVE
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City | GLENDALE
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State | CA
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Zip | 91205-3204
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Country | US
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Telephone | 818-334-5330
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11412
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City | GLENDALE
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State | CA
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Zip | 91226-7412
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Country | US
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Telephone | 818-334-5330
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KARINE TAGMAZYAN
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Credential | MD
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Telephone | 818-334-5330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A122509
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License Number State | CA
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