Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A115637 | CA |
NPI | 1174751382 |
---|---|
Provider Name | Dr. Varaz Bozoghlanian |
First Address | Los Angeles, CA 90064-1524 |
Second Address | Tarzana, CA 91356-3552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 05/02/2020 |