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General NPI Number Information
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NPI Number | 1851819577
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Entity Type | Individual
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Provider Name | EDWARD AGAZARYAN OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 7300 MEDICAL CENTER DR
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City | WEST HILLS
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State | CA
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Zip | 91307-1902
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Country | US
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Telephone | 818-676-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1540 ALCAZAR ST STE 133
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City | LOS ANGELES
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State | CA
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Zip | 90089-0080
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 20510
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License Number State | CA
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