Provider Demographics
NPI:1932964970
Name:BOYNAGIRYAN, SERZH (FNP)
Entity Type:Individual
Prefix:
First Name:SERZH
Middle Name:
Last Name:BOYNAGIRYAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 S GLENDALE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-3388
Mailing Address - Country:US
Mailing Address - Phone:424-489-1537
Mailing Address - Fax:818-500-0509
Practice Address - Street 1:1241 S GLENDALE AVE STE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-3388
Practice Address - Country:US
Practice Address - Phone:424-489-1537
Practice Address - Fax:818-500-0509
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95273871163W00000X
CA95028967363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse