Provider Demographics
NPI:1295104206
Name:SARKISSIAN, LALAGIN (RD)
Entity type:Individual
Prefix:
First Name:LALAGIN
Middle Name:
Last Name:SARKISSIAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N PACIFIC AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-4311
Mailing Address - Country:US
Mailing Address - Phone:818-244-9929
Mailing Address - Fax:
Practice Address - Street 1:1101 N PACIFIC AVE STE 102
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-4311
Practice Address - Country:US
Practice Address - Phone:818-244-9929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
CA86017373133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered