Provider Demographics
NPI:1821396912
Name:SARKISIAN, KARO
Entity Type:Individual
Prefix:MR
First Name:KARO
Middle Name:
Last Name:SARKISIAN
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 1:519 JUSTIN AVE
Mailing Address - Street 2:#1
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91201
Mailing Address - Country:US
Mailing Address - Phone:323-428-5951
Mailing Address - Fax:818-247-7679
Practice Address - Street 1:520 E. BROADWAY ST.
Practice Address - Street 2:#302
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4912
Practice Address - Country:US
Practice Address - Phone:818-247-3166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2483225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist