Provider Demographics
NPI:1477711661
Name:KAZARIAN, VAHE (MD)
Entity type:Individual
Prefix:
First Name:VAHE
Middle Name:
Last Name:KAZARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4735 S DURANGO DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8164
Mailing Address - Country:US
Mailing Address - Phone:725-735-7338
Mailing Address - Fax:818-504-8487
Practice Address - Street 1:4735 S DURANGO DR STE 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8164
Practice Address - Country:US
Practice Address - Phone:725-735-7338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-25
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA104760207Q00000X
NV24446207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCZ012YMedicare PIN
NVCZ012ZMedicare PIN
NVCZ012ZMedicare PIN