Provider Demographics
NPI:1649402678
Name:AVOIAN, TIGRAN (MD)
Entity Type:Individual
Prefix:
First Name:TIGRAN
Middle Name:
Last Name:AVOIAN
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 1:615 E LOMITA AVE
Mailing Address - Street 2:# 6
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-2277
Mailing Address - Country:US
Mailing Address - Phone:818-291-9704
Mailing Address - Fax:
Practice Address - Street 1:2400 S FLOWER ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90007-2629
Practice Address - Country:US
Practice Address - Phone:213-742-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-08
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 109124207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services