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NPI Code Detail

MEDICARE: DR. MARY KOCHARYAN

MEDICARE: DR. MARY KOCHARYAN
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 : 1831027614
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY KOCHARYAN
Provider Business Mailing Address
First Line : 1509 WILSON TER
Second Line :
City : GLENDALE
State : CA
Zip : 91206-4007
Country : US
Telephone Number : 818-409-8000
Fax Number :
Provider Business Practice Location Address
First Line : 1509 WILSON TER
Second Line :
City : GLENDALE
State : CA
Zip : 91206-4007
Country : US
Telephone Number : 818-409-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 06/02/2026

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