Provider Demographics
NPI:1497781603
Name:BARSUMIAN, MARINA G (CRNA)
Entity Type:Individual
Prefix:MS
First Name:MARINA
Middle Name:G
Last Name:BARSUMIAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11928 DUNNICLIFFE CT
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1324
Mailing Address - Country:US
Mailing Address - Phone:818-360-5653
Mailing Address - Fax:909-985-3858
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2009
Practice Address - Country:US
Practice Address - Phone:909-946-5752
Practice Address - Fax:909-985-3858
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA417367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered