Provider Demographics
NPI:1497804561
Name:ZANAZANIAN, MARINA (DC)
Entity Type:Individual
Prefix:DR
First Name:MARINA
Middle Name:
Last Name:ZANAZANIAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14426 GILMORE ST
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1429
Mailing Address - Country:US
Mailing Address - Phone:818-997-9007
Mailing Address - Fax:818-997-9008
Practice Address - Street 1:14426 GILMORE ST UNIT B
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1429
Practice Address - Country:US
Practice Address - Phone:818-997-9007
Practice Address - Fax:818-997-9008
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2009-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor