Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 20093 | CA |
NPI | 1043576077 |
---|---|
Provider Name | Ms. Talar Shant Papazian |
First Address | Granada Hills, CA 91344-5429 |
Second Address | Los Angeles, CA 90095-8358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 03/04/2012 |