Provider Demographics
NPI:1376558718
Name:TSATURYAN, VIGEN
Entity type:Individual
Prefix:MR
First Name:VIGEN
Middle Name:
Last Name:TSATURYAN
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 1:10804 VINEDALE ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2845
Mailing Address - Country:US
Mailing Address - Phone:818-771-9050
Mailing Address - Fax:818-771-9212
Practice Address - Street 1:10804 VINEDALE ST
Practice Address - Street 2:10804 VINDALE ST
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2845
Practice Address - Country:US
Practice Address - Phone:818-771-9050
Practice Address - Fax:818-771-9212
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128413332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies