Provider Demographics
NPI:1801411335
Name:BABASYAN, DIANA
Entity Type:Individual
Prefix:MISS
First Name:DIANA
Middle Name:
Last Name:BABASYAN
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 1:5658 SEPULVEDA BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2927
Mailing Address - Country:US
Mailing Address - Phone:818-208-9067
Mailing Address - Fax:818-208-9047
Practice Address - Street 1:5658 SEPULVEDA BLVD STE 100
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2927
Practice Address - Country:US
Practice Address - Phone:818-208-9067
Practice Address - Fax:818-208-9047
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based