Provider Demographics
NPI:1417911314
Name:ISRAELIAN, ZARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ZARMEN
Middle Name:
Last Name:ISRAELIAN
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 1:801 S CHEVY CHASE DR
Mailing Address - Street 2:#102
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4431
Mailing Address - Country:US
Mailing Address - Phone:818-265-2242
Mailing Address - Fax:818-265-2241
Practice Address - Street 1:801 S CHEVY CHASE DR
Practice Address - Street 2:#102
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4431
Practice Address - Country:US
Practice Address - Phone:818-265-2242
Practice Address - Fax:818-265-2241
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA56455207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG74832Medicare UPIN