Provider Demographics
NPI:1174544001
Name:VARTIVARIAN, ZAREH HAIGAZOUN (MD)
Entity type:Individual
Prefix:DR
First Name:ZAREH
Middle Name:HAIGAZOUN
Last Name:VARTIVARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 WOODLAKE AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1468
Mailing Address - Country:US
Mailing Address - Phone:818-883-8477
Mailing Address - Fax:818-883-2223
Practice Address - Street 1:7320 WOODLAKE AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1468
Practice Address - Country:US
Practice Address - Phone:818-883-8477
Practice Address - Fax:818-883-2223
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC40219174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA88170Medicare UPIN
CAC40219Medicare ID - Type Unspecified