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Individual

DR. BORIS MARDIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD.

Contact information

Practice address
113 E BROADWAY, GLENDALE, CA 91205-1006
(818) 241-7719
(818) 241-0507
Mailing address
113 E BROADWAY, GLENDALE, CA 91205-1006
(818) 241-7719
(818) 241-0507

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11702
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00117020
CA
Enumeration date
07/14/2006
Last updated
07/21/2020
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