Provider Demographics
NPI:1972875730
Name:MAREHBIAN, JONATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:MAREHBIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ASHDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2404
Mailing Address - Country:US
Mailing Address - Phone:310-613-1319
Mailing Address - Fax:
Practice Address - Street 1:9763 W PICO BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4749
Practice Address - Country:US
Practice Address - Phone:424-234-1118
Practice Address - Fax:888-959-1481
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1510522084A2900X
MS258412084N0400X
ARE-118272084N0400X
TN569202084N0400X
CT556172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care