Provider Demographics
NPI:1487262861
Name:TAMRAZYAN, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:TAMRAZYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26836 SEA COVE LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26836 SEA COVE LN
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1625
Practice Address - Country:US
Practice Address - Phone:818-726-9782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2025-06-18
Deactivation Date:2025-04-30
Deactivation Code:
Reactivation Date:2025-06-18
Provider Licenses
StateLicense IDTaxonomies
CA95010159363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care