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Andranik Anthony Agazaryan

Internal Medicine

Allopathic & Osteopathic Physicians

4733 W Sunset Blvd, 3rd Floor, Los Angeles, CA 90027-6021

PECOS Enrollment

This provider is enrolled in PECOS as ANDRANIK AGAZARYAN.

Based on the most recent information from CMS, provider Andranik Anthony Agazaryan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1326401852
Provider Type
Individual
Full Name
Agazaryan, Andranik Anthony
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
4/1/2016
Last Updated
12/13/2021

Contact Information

Practice Location

4733 W Sunset Blvd, 3rd Floor, Los Angeles, CA 90027-6021

(323) 783-4516

Unlisted Fax

Mailing Location

PO Box 250932, Glendale, CA 91225-0932

(818) 640-2433

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License A155722 California
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Andranik Anthony Agazaryan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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