Provider Demographics
NPI:1841377561
Name:KARAYAN, SOOREN (MD)
Entity type:Individual
Prefix:MR
First Name:SOOREN
Middle Name:
Last Name:KARAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SOOREN
Other - Middle Name:
Other - Last Name:KARAYAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD INC
Mailing Address - Street 1:1510 S CENTRAL AVE
Mailing Address - Street 2:#500
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204
Mailing Address - Country:US
Mailing Address - Phone:818-507-0686
Mailing Address - Fax:818-507-6123
Practice Address - Street 1:1510 S CENTRAL AVE
Practice Address - Street 2:#500
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204
Practice Address - Country:US
Practice Address - Phone:818-507-0686
Practice Address - Fax:818-507-6123
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA31692207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A316921Medicaid
CA200003625OtherAARP
CA200003625OtherAARP
CA00A316921Medicaid