Provider Demographics
NPI:1639106230
Name:ZARGARIAN, VIGEN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:VIGEN
Middle Name:
Last Name:ZARGARIAN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1605
Mailing Address - Country:US
Mailing Address - Phone:818-957-2224
Mailing Address - Fax:818-957-2261
Practice Address - Street 1:2048 MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1605
Practice Address - Country:US
Practice Address - Phone:818-957-2224
Practice Address - Fax:818-957-2261
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA671070208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A671070Medicaid
CAA671070Medicare ID - Type Unspecified