1043745821 NPI number — PUZANT TOPALJEKIAN M.D.

Table of content: PUZANT TOPALJEKIAN M.D. (NPI 1043745821)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043745821 NPI number — PUZANT TOPALJEKIAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOPALJEKIAN
Provider First Name:
PUZANT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043745821
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5121 VAN NUYS BLVD STE 211
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHERMAN OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91403-6124
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-891-1000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5121 VAN NUYS BLVD STE 211
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERMAN OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91403-6124
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-891-1000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/28/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  ML60756248 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: MD60963491 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207QH0002X , with the licence number: A164802 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2080267 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".