Provider Demographics
NPI:1184728552
Name:ATOYAN, ARSEN
Entity type:Individual
Prefix:MR
First Name:ARSEN
Middle Name:
Last Name:ATOYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:MISS
Other - First Name:ARSEN
Other - Middle Name:
Other - Last Name:ATOYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4613 1/2 VALLEY BL
Mailing Address - Street 2:
Mailing Address - City:LA
Mailing Address - State:CA
Mailing Address - Zip Code:90032-3831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4613 1/2 VALLEY BL
Practice Address - Street 2:
Practice Address - City:LA
Practice Address - State:CA
Practice Address - Zip Code:90032-3831
Practice Address - Country:US
Practice Address - Phone:818-300-7090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0002023243-0001-7332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5580750001Medicare NSC