Provider Demographics
NPI:1851561807
Name:TATULIAN, KARMEN SERGEI (MD)
Entity Type:Individual
Prefix:
First Name:KARMEN
Middle Name:SERGEI
Last Name:TATULIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KARMEN
Other - Middle Name:SERGEI
Other - Last Name:VARTANIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8902 WOODMAN AVENUE
Mailing Address - Street 2:EL PROYECTO DEL BARRIO, INC.
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331
Mailing Address - Country:US
Mailing Address - Phone:818-830-7033
Mailing Address - Fax:
Practice Address - Street 1:8902 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6401
Practice Address - Country:US
Practice Address - Phone:818-830-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 101992208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice