| Shant Kazazian Md Inc. | |
|
204 E Chevy Chase Dr Ste 2 Glendale CA 91205-3181 | |
| (818) 545-9090 | |
| (818) 545-9098 |
| Full Name | Shant Kazazian Md Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 204 E Chevy Chase Dr Ste 2, Glendale, California |
| Authorized Official Name and Position | Shant Kazazian (CEO) |
| Authorized Official Contact | 3233040975 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shant Kazazian Md Inc. 204 E Chevy Chase Dr Ste 2 Glendale CA 91205-3181 Ph: (818) 545-9090 | Shant Kazazian Md Inc. 204 E Chevy Chase Dr Ste 2 Glendale CA 91205-3181 Ph: (818) 545-9090 |
| NPI Number | 1528377694 |
|---|---|
| Provider Enumeration Date | 10/06/2010 |
| Last Update Date | 07/07/2013 |
| Medicare PECOS PAC ID | 0143415760 |
|---|---|
| Medicare Enrollment ID | O20101109000975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528377694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A94612 (California) | Primary |
| Provider Name | Shant Kazazian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982646741 PECOS PAC ID: 0941202675 Enrollment ID: I20070209000298 |
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