Provider Demographics
NPI:1477966885
Name:GAZARIAN, MARAL CHRISTINE (DO)
Entity Type:Individual
Prefix:
First Name:MARAL
Middle Name:CHRISTINE
Last Name:GAZARIAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 W DUARTE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9273
Mailing Address - Country:US
Mailing Address - Phone:626-755-6858
Mailing Address - Fax:626-447-7637
Practice Address - Street 1:622 W DUARTE RD STE 203
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9273
Practice Address - Country:US
Practice Address - Phone:626-446-1190
Practice Address - Fax:626-447-7637
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSL1014207R00000X
VA0102204895207R00000X
CA20A15508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine