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General NPI Number Information
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NPI Number | 1992521033
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Entity Type | Individual
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Provider Name | LEVON KTRATSYAN FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 8055 FOOTHILL BLVD
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City | SUNLAND
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State | CA
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Zip | 91040-2943
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Country | US
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Telephone | 818-237-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 806 E LOMITA AVE APT E
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City | GLENDALE
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State | CA
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Zip | 91205-1866
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Country | US
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Telephone | 818-237-6200
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95033097
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License Number State | CA
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