Provider Demographics
NPI:1487880506
Name:ASIRYAN, VARDUI (MD)
Entity type:Individual
Prefix:DR
First Name:VARDUI
Middle Name:
Last Name:ASIRYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N SAN FERNANDO BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4236
Mailing Address - Country:US
Mailing Address - Phone:818-414-1083
Mailing Address - Fax:818-484-8879
Practice Address - Street 1:1411 W OLIVE AVE STE D
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2400
Practice Address - Country:US
Practice Address - Phone:818-484-8380
Practice Address - Fax:818-484-8879
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128242207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1508221607OtherNPI TYPE 2