Provider Demographics
NPI:1619267424
Name:DJABRAYAN, VARTAN JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:VARTAN
Middle Name:JOHN
Last Name:DJABRAYAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E MINARETS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93650-1215
Mailing Address - Country:US
Mailing Address - Phone:559-307-4400
Mailing Address - Fax:559-412-4394
Practice Address - Street 1:30 E MINARETS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93650-1215
Practice Address - Country:US
Practice Address - Phone:559-307-4400
Practice Address - Fax:559-412-4394
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25132111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor