Provider Demographics
NPI:1376361956
Name:BULUTYAN, ARAM (NP)
Entity type:Individual
Prefix:
First Name:ARAM
Middle Name:
Last Name:BULUTYAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 MIRA LOMA AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-3510
Mailing Address - Country:US
Mailing Address - Phone:818-984-7152
Mailing Address - Fax:
Practice Address - Street 1:328 MIRA LOMA AVE APT 101
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-3510
Practice Address - Country:US
Practice Address - Phone:818-984-7152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95032271363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily