MEDICARE: AGHASI HARUTYUNYAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	264771	CA

General Provider Information

NPI Number	:	1063367019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AGHASI HARUTYUNYAN

Provider Business Mailing Address
First Line	:	820 THOMPSON AVE STE 30
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-2049
Country	:	US
Telephone Number	:	818-649-1799
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 THOMPSON AVE STE 30
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91201-2049
Country	:	US
Telephone Number	:	818-649-1799
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ AGHASI HARUTYUNYAN ” Practice Location

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