Provider Demographics
NPI:1508498130
Name:NARE STEPANYAN MD INC
Entity Type:Organization
Organization Name:NARE STEPANYAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NARE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-675-3257
Mailing Address - Street 1:1030 S GLENDALE AVE STE 503
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2820
Mailing Address - Country:US
Mailing Address - Phone:818-547-3380
Mailing Address - Fax:
Practice Address - Street 1:1030 S GLENDALE AVE STE 503
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-2820
Practice Address - Country:US
Practice Address - Phone:818-547-3380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty