Provider Demographics
NPI:1851573752
Name:GASPARYAN, KARINE
Entity Type:Individual
Prefix:
First Name:KARINE
Middle Name:
Last Name:GASPARYAN
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 1:21827 ELKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91304-4853
Mailing Address - Country:US
Mailing Address - Phone:818-522-2787
Mailing Address - Fax:818-884-6075
Practice Address - Street 1:21740 DEVONSHIRE ST
Practice Address - Street 2:SUITE #3
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-2903
Practice Address - Country:US
Practice Address - Phone:818-522-2787
Practice Address - Fax:818-884-6075
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41-22446312471M2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M2300XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMammography