Provider Demographics
NPI:1972272821
Name:AIVAZIAN, AROUTIN (DPT)
Entity Type:Individual
Prefix:
First Name:AROUTIN
Middle Name:
Last Name:AIVAZIAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N ROBERTSON BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-6001
Mailing Address - Country:US
Mailing Address - Phone:310-273-7800
Mailing Address - Fax:
Practice Address - Street 1:200 N ROBERTSON BLVD STE 301
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-6001
Practice Address - Country:US
Practice Address - Phone:310-273-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300978225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist