Provider Demographics
NPI:1235359845
Name:KAZANCHIAN, ARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMEN
Middle Name:
Last Name:KAZANCHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N PACIFIC AVE
Mailing Address - Street 2:SUITE # 103
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3250
Mailing Address - Country:US
Mailing Address - Phone:818-247-7447
Mailing Address - Fax:818-247-1484
Practice Address - Street 1:1101 N PACIFIC AVE
Practice Address - Street 2:SUITE # 103
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3250
Practice Address - Country:US
Practice Address - Phone:818-247-7447
Practice Address - Fax:818-247-1484
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA053993207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG-61342Medicare UPIN