Provider Demographics
NPI:1396263240
Name:MAZMANYAN, MELINE (MA)
Entity type:Individual
Prefix:
First Name:MELINE
Middle Name:
Last Name:MAZMANYAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8329 GRENOBLE ST UNIT 48
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2858
Mailing Address - Country:US
Mailing Address - Phone:818-649-0930
Mailing Address - Fax:
Practice Address - Street 1:6736 LAUREL CANYON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1576
Practice Address - Country:US
Practice Address - Phone:818-755-8786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program