Provider Demographics
NPI:1578247607
Name:BAGHRAMYAN, SEVAK ABRAAMOVICH
Entity Type:Individual
Prefix:
First Name:SEVAK
Middle Name:ABRAAMOVICH
Last Name:BAGHRAMYAN
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 1:7616 HOLLYWOOD BLVD APT 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-2706
Mailing Address - Country:US
Mailing Address - Phone:818-577-9596
Mailing Address - Fax:
Practice Address - Street 1:7616 HOLLYWOOD BLVD APT 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-2706
Practice Address - Country:US
Practice Address - Phone:818-577-9596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT23387225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist