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General NPI Number Information
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NPI Number | 1861269334
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Entity Type | Individual
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Provider Name | VERZHINE KOROGLYAN
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Gender | Female
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Dates
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Enumeration Date | 12/05/2023
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Last Update Date | 12/05/2023
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Provider Practice Location Address
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Address Line | 2701 W ALAMEDA AVE STE 302
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City | BURBANK
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State | CA
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Zip | 91505-4408
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Country | US
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Telephone | 747-247-1130
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Fax |
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Provider Business Mailing Address
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Address Line | 8112 LAURELGROVE AVE
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City | N HOLLYWOOD
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State | CA
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Zip | 91605-1315
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Country | US
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Telephone | 213-284-0016
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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 | 164X00000X
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Taxonomy Name | Licensed Vocational Nurse
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License Number | 222138
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License Number State | CA
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