Organization Active NPI

Kayichian Despina, M.D., Inc

  • Nephrology Physician
  • Glendale, CA
National Provider Identifier
1043371172
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A052950 Issued in CA
Legal business name
KAYICHIAN DESPINA, M.D., INC
Practice address
1510 S Central Ave
Suite 210
Glendale, CA 91204-2500
Phone
(818) 241-7628
Fax
(818) 241-7639
NPI assigned
Dec 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Despina Ghaby Kayichian, M.D.
Title
President
Phone
(818) 241-7628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X A052950 CA Primary

Addresses

Primary practice location

1510 S Central Ave
Suite 210
Glendale, CA 91204-2500

Mailing address

1510 S Central Ave
Suite 210
Glendale, CA 91204-2500
Phone (818) 241-7628

National Provider Directory

National Provider Directory

Locations

1560 E Chevy Chase Dr
Ste 220
Glendale, CA 91206
Phone (818) 241-7628

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043371172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE",
            "address_2": "SUITE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042500",
            "telephone_number": "818-241-7628",
            "fax_number": "818-241-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S CENTRAL AVE",
            "address_2": "SUITE 210",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042500",
            "telephone_number": "818-241-7628",
            "fax_number": "818-241-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAYICHIAN DESPINA, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAYICHIAN",
        "authorized_official_first_name": "DESPINA",
        "authorized_official_middle_name": "GHABY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-241-7628",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A052950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.