Provider Demographics
NPI:1710162482
Name:ZOKIAN, GHAZAR GUS
Entity Type:Individual
Prefix:MR
First Name:GHAZAR
Middle Name:GUS
Last Name:ZOKIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 S CENTRAL AVE
Mailing Address - Street 2:UNIT 107
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2061
Mailing Address - Country:US
Mailing Address - Phone:818-244-1600
Mailing Address - Fax:818-244-4877
Practice Address - Street 1:730 S CENTRAL AVE
Practice Address - Street 2:UNIT 107
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2061
Practice Address - Country:US
Practice Address - Phone:818-244-1600
Practice Address - Fax:818-244-4877
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies