Provider Demographics
NPI:1821171604
Name:BEZIKIAN, HAGOP (MD)
Entity Type:Individual
Prefix:DR
First Name:HAGOP
Middle Name:
Last Name:BEZIKIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HAIG
Other - Middle Name:
Other - Last Name:BEZIKIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1340 N VIRGIL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6026
Mailing Address - Country:US
Mailing Address - Phone:323-664-0013
Mailing Address - Fax:323-664-0212
Practice Address - Street 1:1340 N VIRGIL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6026
Practice Address - Country:US
Practice Address - Phone:323-664-0013
Practice Address - Fax:323-664-0212
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine