Provider Demographics
NPI:1821173477
Name:AYVAZIAN, HAIG (DC)
Entity Type:Individual
Prefix:
First Name:HAIG
Middle Name:
Last Name:AYVAZIAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N.CENTRAL AVENUE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3358
Mailing Address - Country:US
Mailing Address - Phone:818-242-3951
Mailing Address - Fax:818-242-4586
Practice Address - Street 1:540 N CENTRAL AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1916
Practice Address - Country:US
Practice Address - Phone:818-242-3951
Practice Address - Fax:818-242-4586
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-24275111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor