Provider Demographics
NPI:1548363641
Name:ZOGRABYAN, ARUS (MD)
Entity type:Individual
Prefix:MRS
First Name:ARUS
Middle Name:
Last Name:ZOGRABYAN
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 1:401 PALM DR APT A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-4371
Mailing Address - Country:US
Mailing Address - Phone:818-244-6857
Mailing Address - Fax:
Practice Address - Street 1:1300 N VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6005
Practice Address - Country:US
Practice Address - Phone:323-953-8821
Practice Address - Fax:323-953-9503
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76345174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA108509Medicare UPIN
CA00A763450Medicare ID - Type Unspecified
CAWA76345AMedicare ID - Type Unspecified