Provider Demographics
NPI:1316983885
Name:TOUKHLADJIAN, NEKTAR HOPE (PT)
Entity type:Individual
Prefix:
First Name:NEKTAR
Middle Name:HOPE
Last Name:TOUKHLADJIAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13633 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1735
Mailing Address - Country:US
Mailing Address - Phone:818-988-7156
Mailing Address - Fax:818-988-7159
Practice Address - Street 1:13633 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91401-1735
Practice Address - Country:US
Practice Address - Phone:818-395-7049
Practice Address - Fax:818-368-1412
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT30080208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA205558370OtherTAX ID
CA205558370OtherTAX ID