Provider Demographics
NPI:1417919507
Name:PEHLEVANIAN, GARO ZAVEN (MD)
Entity Type:Individual
Prefix:
First Name:GARO
Middle Name:ZAVEN
Last Name:PEHLEVANIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5250 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90029-1252
Mailing Address - Country:US
Mailing Address - Phone:323-664-0857
Mailing Address - Fax:323-664-9702
Practice Address - Street 1:5250 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1252
Practice Address - Country:US
Practice Address - Phone:323-664-0857
Practice Address - Fax:323-664-9702
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA38617207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A386170Medicaid
CAA85153Medicare UPIN
CA00A386170Medicaid