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NPI Code Detail

MEDICARE: DIANA OGANESYAN NP

MEDICARE: DIANA OGANESYAN NP
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
1363L00000XNurse Practitioner95139610CA

General Provider Information

NPI Number : 1528915352
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA OGANESYAN NP
Provider Business Mailing Address
First Line : 10630 MOORPARK ST
Second Line :
City : TOLUCA LAKE
State : CA
Zip : 91602-2796
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 DUARTE RD
Second Line :
City : DUARTE
State : CA
Zip : 91010-3012
Country : US
Telephone Number : 818-395-5837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2026
Last Update Date : 03/11/2026

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