Basic Information
Provider Information
NPI: 1881208072
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANIELYAN
FirstName: ARA
MiddleName:  
NamePrefix:  
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Credential:  
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OtherOrganizationType:  
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Mailing Information
Address1: 8110 WOODMAN AVE BLDG 5
Address2:  
City: PANORAMA CITY
State: CA
PostalCode: 91402
CountryCode: US
TelephoneNumber: 8183752000
FaxNumber:  
Practice Location
Address1: 8110 WOODMAN AVE BLDG 5
Address2:  
City: PANORAMA CITY
State: CA
PostalCode: 91402
CountryCode: US
TelephoneNumber: 8183752000
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/04/2020
LastUpdateDate: 09/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2279C0205X  N Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
2279E0002X  N Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredEmergency Care
227900000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered 

No ID Information.


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