Provider Demographics
NPI:1508636424
Name:ARAKELYAN, SYUZANNA (RDMS)
Entity Type:Individual
Prefix:
First Name:SYUZANNA
Middle Name:
Last Name:ARAKELYAN
Suffix:
Gender:F
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 E MAPLE ST APT 102
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1848
Mailing Address - Country:US
Mailing Address - Phone:818-205-5030
Mailing Address - Fax:
Practice Address - Street 1:801 E MAPLE ST APT 102
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1848
Practice Address - Country:US
Practice Address - Phone:818-205-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2805512085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound