Provider Demographics
NPI:1568468650
Name:VORPERIAN, KEVORK ARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVORK
Middle Name:ARTIN
Last Name:VORPERIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1110
Mailing Address - Country:US
Mailing Address - Phone:818-409-3020
Mailing Address - Fax:818-243-2713
Practice Address - Street 1:8134 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SUNLAND
Practice Address - State:CA
Practice Address - Zip Code:91040-2941
Practice Address - Country:US
Practice Address - Phone:818-962-0715
Practice Address - Fax:818-962-0714
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC50258207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A58500Medicare UPIN
CAC50258Medicare ID - Type Unspecified
CAC50258AMedicare ID - Type Unspecified