Provider Demographics
NPI:1578616553
Name:DAVTYAN, ARAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ARAM
Middle Name:
Last Name:DAVTYAN
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 1:9301 OAKDALE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-6515
Mailing Address - Country:US
Mailing Address - Phone:818-838-4561
Mailing Address - Fax:
Practice Address - Street 1:9301 OAKDALE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-6515
Practice Address - Country:US
Practice Address - Phone:818-838-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA115648207Q00000X
NV14115207Q00000X
NH15101207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1578616553Medicaid
CACB247636Medicare PIN
NV1578616553Medicaid
NVFR068YMedicare PIN