Provider Demographics
NPI:1841248309
Name:ARUTYOUNIAN, NARINE (MD)
Entity type:Individual
Prefix:DR
First Name:NARINE
Middle Name:
Last Name:ARUTYOUNIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 E. BROADWAY ST.
Mailing Address - Street 2:#1
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1218
Mailing Address - Country:US
Mailing Address - Phone:818-265-5040
Mailing Address - Fax:
Practice Address - Street 1:814 E BROADWAY
Practice Address - Street 2:SUITE 1
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1218
Practice Address - Country:US
Practice Address - Phone:818-265-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72468207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A724680Medicaid
CAW16481Medicare PIN
CA00A724680Medicaid