Provider Demographics
NPI:1013595610
Name:KARAGEUZIAN, RAZMIG ALAIN
Entity type:Individual
Prefix:
First Name:RAZMIG
Middle Name:ALAIN
Last Name:KARAGEUZIAN
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 1:18418 HASTINGS WAY
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2033
Mailing Address - Country:US
Mailing Address - Phone:818-488-1567
Mailing Address - Fax:
Practice Address - Street 1:18418 HASTINGS WAY
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-2033
Practice Address - Country:US
Practice Address - Phone:818-488-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF6887550390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program