Provider Demographics
NPI:1942911300
Name:M GAZARIAN MEDICAL CORPORATION
Entity Type:Organization
Organization Name:M GAZARIAN MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GAZARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:626-755-6858
Mailing Address - Street 1:622 W DUARTE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9273
Mailing Address - Country:US
Mailing Address - Phone:626-446-1190
Mailing Address - Fax:626-447-7637
Practice Address - Street 1:622 W DUARTE RD STE 203
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9273
Practice Address - Country:US
Practice Address - Phone:626-446-1190
Practice Address - Fax:626-447-7637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty