Provider Demographics
NPI:1558868901
Name:PEVAZEAN, ARMEN
Entity Type:Individual
Prefix:
First Name:ARMEN
Middle Name:
Last Name:PEVAZEAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 6TH ST APT C
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-2328
Mailing Address - Country:US
Mailing Address - Phone:310-683-8369
Mailing Address - Fax:
Practice Address - Street 1:13609 VICTORY BLVD # 218
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1736
Practice Address - Country:US
Practice Address - Phone:818-434-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based