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NPI Code Detail

MEDICARE: NICHOLAS SEVAG KOPOOSHIAN

MEDICARE:   NICHOLAS SEVAG KOPOOSHIAN
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1205779642
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS SEVAG KOPOOSHIAN
Provider Business Mailing Address
First Line : 14445 OLIVE VIEW DR
Second Line :
City : SYLMAR
State : CA
Zip : 91342-1437
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14445 OLIVE VIEW DR
Second Line :
City : SYLMAR
State : CA
Zip : 91342-1437
Country : US
Telephone Number : 747-210-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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Directions to “ NICHOLAS SEVAG KOPOOSHIAN ” Practice Location

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