Provider Demographics
NPI:1588430383
Name:BAGHDASARYAN, MARGARIT (FNP)
Entity type:Individual
Prefix:
First Name:MARGARIT
Middle Name:
Last Name:BAGHDASARYAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16711 LAHEY ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4212
Mailing Address - Country:US
Mailing Address - Phone:818-326-8426
Mailing Address - Fax:
Practice Address - Street 1:16711 LAHEY ST
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4212
Practice Address - Country:US
Practice Address - Phone:818-326-8426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95925809207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine