Provider Demographics
NPI:1760563340
Name:SARYAN, PAYTSAR PAULA
Entity Type:Individual
Prefix:
First Name:PAYTSAR
Middle Name:PAULA
Last Name:SARYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 MARY ST
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2557
Mailing Address - Country:US
Mailing Address - Phone:818-248-2354
Mailing Address - Fax:
Practice Address - Street 1:3335 MARY ST
Practice Address - Street 2:
Practice Address - City:LA CRESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214-2557
Practice Address - Country:US
Practice Address - Phone:818-248-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner