Provider Demographics
NPI:1013028026
Name:VARTANIAN, GAREN (DC)
Entity Type:Individual
Prefix:MR
First Name:GAREN
Middle Name:
Last Name:VARTANIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 N HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-1630
Mailing Address - Country:US
Mailing Address - Phone:626-918-9542
Mailing Address - Fax:
Practice Address - Street 1:1228 N HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:LA PUENTE
Practice Address - State:CA
Practice Address - Zip Code:91744-1630
Practice Address - Country:US
Practice Address - Phone:626-918-9542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor