Provider Demographics
NPI:1588478200
Name:AVAKYAN, ARTUR
Entity type:Individual
Prefix:
First Name:ARTUR
Middle Name:
Last Name:AVAKYAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 W OLIVE AVE UNIT O
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2625
Mailing Address - Country:US
Mailing Address - Phone:747-966-7977
Mailing Address - Fax:914-810-9595
Practice Address - Street 1:2225 W OLIVE AVE UNIT O
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2625
Practice Address - Country:US
Practice Address - Phone:747-966-7977
Practice Address - Fax:914-810-9595
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAY6400798343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)