Provider Demographics
NPI:1689132532
Name:KRAJIAN, KEVORK (RDMS)
Entity Type:Individual
Prefix:
First Name:KEVORK
Middle Name:
Last Name:KRAJIAN
Suffix:
Gender:M
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2645 RISA DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-2355
Mailing Address - Country:US
Mailing Address - Phone:818-433-1993
Mailing Address - Fax:818-245-6335
Practice Address - Street 1:2645 RISA DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-2355
Practice Address - Country:US
Practice Address - Phone:818-433-1993
Practice Address - Fax:818-245-6335
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-11
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1694292471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty