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Licensing details for: A 204923

Name: MAKARYAN, TADEVOS TODD

License Type: Physician and Surgeon A

Primary Status: License Renewed & Current Primary Status Definition

School Name: Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine

Graduation Year: 2023

Address of Record

12612 Gilmore St
NORTH HOLLYWOOD CA 91606-1245
LOS ANGELES county
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Issuance Date

September 5, 2025

Expiration Date

November 30, 2027

Current Date / Time

April 14, 2026
3:24:25 PM

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Public Documents

License Relationships

Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Physician & Surgeon

Related Party Role: Postgraduate Training License

Name: MAKARYAN, TADEVOS TODD

License/Registration Type: Postgraduate Training License

License Number: 13568 Primary Status: License Canceled

Address :
12612 Gilmore St
NORTH HOLLYWOOD CA 91606-1245
LOS ANGELES COUNTY

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Survey Information

The following information is self-reported by the licensee and has not been verified by the Board.

No AB 133 Survey Information Provided by Licensee

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