Provider Demographics
NPI:1831921931
Name:KARAPETYAN, SARGIS
Entity type:Individual
Prefix:
First Name:SARGIS
Middle Name:
Last Name:KARAPETYAN
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 1:1146 E LEXINGTON DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-3844
Mailing Address - Country:US
Mailing Address - Phone:747-331-0162
Mailing Address - Fax:
Practice Address - Street 1:1146 E LEXINGTON DR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-3844
Practice Address - Country:US
Practice Address - Phone:747-331-0162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide