Provider Demographics
NPI:1275019630
Name:MARZVANYAN, MARIANNA (RD)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:MARZVANYAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12605 VENTURA BLVD # 1021
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-2415
Mailing Address - Country:US
Mailing Address - Phone:818-618-9884
Mailing Address - Fax:
Practice Address - Street 1:10942 KESWICK ST APT 1
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-4580
Practice Address - Country:US
Practice Address - Phone:818-618-9884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered