Provider Demographics
NPI:1770901985
Name:GABRIELYAN, ARAM
Entity type:Individual
Prefix:
First Name:ARAM
Middle Name:
Last Name:GABRIELYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N CENTRAL AVE STE 740
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-3953
Mailing Address - Country:US
Mailing Address - Phone:424-424-0402
Mailing Address - Fax:
Practice Address - Street 1:500 N CENTRAL AVE STE 740
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3953
Practice Address - Country:US
Practice Address - Phone:424-424-0402
Practice Address - Fax:833-651-2094
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA151720207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty