Provider Demographics
NPI:1760281307
Name:DUZARYAN, SAMUEL KARO (DC)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:KARO
Last Name:DUZARYAN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11611 TAMPA AVE UNIT 189
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1468
Mailing Address - Country:US
Mailing Address - Phone:818-523-6661
Mailing Address - Fax:
Practice Address - Street 1:815 E COLORADO ST STE 250
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4510
Practice Address - Country:US
Practice Address - Phone:818-523-6661
Practice Address - Fax:818-246-3604
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37201111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic