Provider Demographics
NPI:1720839277
Name:DAGHLIAN, RINA TALIN
Entity Type:Individual
Prefix:
First Name:RINA
Middle Name:TALIN
Last Name:DAGHLIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18370 BURBANK BLVD STE 412
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2844
Mailing Address - Country:US
Mailing Address - Phone:818-506-3384
Mailing Address - Fax:
Practice Address - Street 1:18370 BURBANK BLVD STE 412
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2844
Practice Address - Country:US
Practice Address - Phone:818-506-3384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95026473207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease