Provider Demographics
NPI:1376397893
Name:KALANTARIAN, HAYK (OT/L)
Entity Type:Individual
Prefix:
First Name:HAYK
Middle Name:
Last Name:KALANTARIAN
Suffix:
Gender:M
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 WESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-3158
Mailing Address - Country:US
Mailing Address - Phone:626-590-6054
Mailing Address - Fax:
Practice Address - Street 1:1155 WESLEY AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-3158
Practice Address - Country:US
Practice Address - Phone:626-590-6054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16939225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist