Provider Demographics
NPI:1598410201
Name:GALADZHYAN, MELANIE IRENE (NP)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:IRENE
Last Name:GALADZHYAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9749 SWINTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-1929
Mailing Address - Country:US
Mailing Address - Phone:818-624-2400
Mailing Address - Fax:
Practice Address - Street 1:7320 WOODLAKE AVE STE 330
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1486
Practice Address - Country:US
Practice Address - Phone:818-346-1773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95018062363LP2300X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care