Provider Demographics
NPI:1649263229
Name:HARUTYUNYAN, HASMIK (RDMS,RDCS,RVT)
Entity type:Individual
Prefix:
First Name:HASMIK
Middle Name:
Last Name:HARUTYUNYAN
Suffix:
Gender:F
Credentials:RDMS,RDCS,RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 YOSEMITE DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2729
Mailing Address - Country:US
Mailing Address - Phone:323-256-1463
Mailing Address - Fax:
Practice Address - Street 1:1700 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-3225
Practice Address - Country:US
Practice Address - Phone:213-484-1289
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA978162471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG459Medicare ID - Type Unspecified