MEDICARE: DIANA TOVMASYAN

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	363L00000X	Nurse Practitioner	95015256	CA

General Provider Information

NPI Number	:	1952065401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA TOVMASYAN

Provider Business Mailing Address
First Line	:	8759 COLLETT AVE
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-4851
Country	:	US
Telephone Number	:	818-668-7606
Fax Number	:

Provider Business Practice Location Address
First Line	:	10711 RIVERSIDE DR
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91602-2312
Country	:	US
Telephone Number	:	818-888-0001
Fax Number	:

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

Provider Enumeration Date	:	10/29/2021
Last Update Date	:	10/29/2021

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Directions to “ DIANA TOVMASYAN ” Practice Location

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