Provider Demographics
NPI:1114819802
Name:KARAPETIAN, TIGRAN
Entity type:Individual
Prefix:
First Name:TIGRAN
Middle Name:
Last Name:KARAPETIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E BROADWAY APT 416
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1090
Mailing Address - Country:US
Mailing Address - Phone:747-221-2428
Mailing Address - Fax:
Practice Address - Street 1:200 E BROADWAY APT 416
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1090
Practice Address - Country:US
Practice Address - Phone:747-221-2428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA99968225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist