Provider Demographics
NPI:1548849631
Name:AVAKIAN, ARMINE (NP)
Entity type:Individual
Prefix:
First Name:ARMINE
Middle Name:
Last Name:AVAKIAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 BUCKINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-1402
Mailing Address - Country:US
Mailing Address - Phone:310-614-2424
Mailing Address - Fax:
Practice Address - Street 1:425 E COLORADO ST STE 420
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-5123
Practice Address - Country:US
Practice Address - Phone:818-502-1341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015748363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty