Provider Demographics
NPI:1144562703
Name:ARUTYUNOV, BORIS S (MD)
Entity type:Individual
Prefix:DR
First Name:BORIS
Middle Name:S
Last Name:ARUTYUNOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11035 MOORPARK ST APT 201
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-3449
Mailing Address - Country:US
Mailing Address - Phone:818-220-4898
Mailing Address - Fax:
Practice Address - Street 1:11035 MOORPARK ST APT 201
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-3449
Practice Address - Country:US
Practice Address - Phone:818-220-4898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA137892207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine