Provider Demographics
NPI:1982867651
Name:KAZANCHIAN & TOVANYAN MEDICAL GROUP
Entity Type:Organization
Organization Name:KAZANCHIAN & TOVANYAN MEDICAL GROUP
Other - Org Name:SC MEDICAL & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROOT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOVANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:818-269-1111
Mailing Address - Street 1:11650 RIVERSIDE DR
Mailing Address - Street 2:STE# 5
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1093
Mailing Address - Country:US
Mailing Address - Phone:818-269-1111
Mailing Address - Fax:818-247-1484
Practice Address - Street 1:11650 RIVERSIDE DR
Practice Address - Street 2:STE# 5
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602-1093
Practice Address - Country:US
Practice Address - Phone:818-269-1111
Practice Address - Fax:818-247-1484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111N00000X
CAA53993207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty