Provider Demographics
NPI:1275109449
Name:VARTANYAN, SUZANA
Entity Type:Individual
Prefix:
First Name:SUZANA
Middle Name:
Last Name:VARTANYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7436 COLDWATER CANYON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-3501
Mailing Address - Country:US
Mailing Address - Phone:818-388-8815
Mailing Address - Fax:
Practice Address - Street 1:7436 COLDWATER CANYON AVE STE 1
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-3501
Practice Address - Country:US
Practice Address - Phone:818-388-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA837777163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice