Provider Demographics
NPI:1679703847
Name:ANNA GHAZANCHYAN
Entity type:Organization
Organization Name:ANNA GHAZANCHYAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZANCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS, RVT
Authorized Official - Phone:818-240-7744
Mailing Address - Street 1:801 S CHEVY CHASE DR
Mailing Address - Street 2:# 60
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-4431
Mailing Address - Country:US
Mailing Address - Phone:818-240-7744
Mailing Address - Fax:818-240-7755
Practice Address - Street 1:801 S CHEVY CHASE DR
Practice Address - Street 2:# 60
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4431
Practice Address - Country:US
Practice Address - Phone:818-240-7744
Practice Address - Fax:818-240-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XC2903XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularVascular SpecialistGroup - Multi-Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularGroup - Multi-Specialty