Provider Demographics
NPI:1942670807
Name:SIMONYAN, EDUARD
Entity Type:Individual
Prefix:
First Name:EDUARD
Middle Name:
Last Name:SIMONYAN
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 1:1747 N NORMANDIE AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-3918
Mailing Address - Country:US
Mailing Address - Phone:818-640-2742
Mailing Address - Fax:
Practice Address - Street 1:1747 N NORMANDIE AVE APT 206
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-3918
Practice Address - Country:US
Practice Address - Phone:818-640-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-04
Last Update Date:2015-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst