Provider Demographics
NPI:1679256267
Name:BABOYAN, ARNAG A (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:ARNAG
Middle Name:A
Last Name:BABOYAN
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 N KENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-4248
Mailing Address - Country:US
Mailing Address - Phone:818-524-9397
Mailing Address - Fax:
Practice Address - Street 1:215 N KENWOOD ST APT 308
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4203
Practice Address - Country:US
Practice Address - Phone:818-524-9397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHT723100174400000X
CA82448225700000X
CAMPSS-NLEIGK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No174400000XOther Service ProvidersSpecialist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist