Provider Demographics
NPI:1780922344
Name:MEYMARYAN, ASHOT (ARDMS,RVT)
Entity type:Individual
Prefix:
First Name:ASHOT
Middle Name:
Last Name:MEYMARYAN
Suffix:
Gender:M
Credentials:ARDMS,RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 N JACKSON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-2014
Mailing Address - Country:US
Mailing Address - Phone:818-441-3443
Mailing Address - Fax:
Practice Address - Street 1:5300 SANTA MONICA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1258
Practice Address - Country:US
Practice Address - Phone:323-461-5882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1107932471S1302X, 2471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography