Individual
MR. GAGIK JACK TAGARYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
19809 ACRE ST, NORTHRIDGE, CA 91324-3302
(818) 414-4050
Mailing address
19809 ACRE ST, NORTHRIDGE, CA 91324-3302
(818) 414-4050
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
655496
CA
Other
Enumeration date
05/26/2010
Last updated
05/26/2010
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