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NPI Code Detail

MEDICARE: ALEXANDER G GEVORGYAN MD INC

MEDICARE: ALEXANDER G GEVORGYAN MD INC
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
12084N0400XNeurology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A133154OTHERCAMEDICAL LICENSE

General Provider Information

NPI Number : 1245939719
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALEXANDER G GEVORGYAN MD INC
Provider Business Mailing Address
First Line : 1332 S GLENDALE AVE
Second Line :
City : GLENDALE
State : CA
Zip : 91205-3349
Country : US
Telephone Number : 818-649-9232
Fax Number :
Provider Business Practice Location Address
First Line : 23928 LYONS AVE STE 102
Second Line :
City : SANTA CLARITA
State : CA
Zip : 91321-2452
Country : US
Telephone Number : 661-222-2326
Fax Number : 661-222-9444
Authorized Official
Title or Position : PRESIDENT
Name : DR. ALEXANDER GEVORGYAN
Credential : MD
Telephone Number : 818-649-9232
Provider Enumeration Date : 02/23/2023
Last Update Date : 02/23/2023

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Directions to “ALEXANDER G GEVORGYAN MD INC ” Practice Location

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