Individual provider Active NPI

Edith Haghnazarian, MD

  • Pediatrics Physician
  • Los Gatos, CA
National Provider Identifier
1043871288
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A178017 Issued in CA
Practice address
15899 Los Gatos Almaden Rd Ste 4
Los Gatos, CA 95032-3739
Phone
(408) 356-7770
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A178017 CA Primary

Addresses

Primary practice location

15899 Los Gatos Almaden Rd Ste 4
Los Gatos, CA 95032-3739

Mailing address

15899 Los Gatos Almaden Rd Ste 4
Los Gatos, CA 95032-3739
Phone (408) 356-7770

Other practice location 1

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 660-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221021001299 CA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1456727080 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A178017CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Los Angeles Medical Group, Inc. Pediatrics CurrentSince Nov 1, 2022 Accepting new patients
LPCH Medical Group Div of Lucile Pediatrics CurrentSince Aug 19, 2025 Accepting new patients

Locations

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

14651 S Bascom Ave
Ste 200
Los Gatos, CA 95032
Phone (408) 356-2154

15899 Los Gatos Almaden Rd
Ste 4
Los Gatos, CA 95032
Phone (408) 356-7770

725 Welch Rd
Palo Alto, CA 94304
Phone (650) 497-8979

Interoperability endpoints

  • Direct secure messaging: ehaghnazarian1311548@direct.uclahealth.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1043871288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15899 LOS GATOS ALMADEN RD STE 4",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323739",
            "telephone_number": "408-356-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15899 LOS GATOS ALMADEN RD STE 4",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950323739",
            "telephone_number": "408-356-7770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-660-2450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGHNAZARIAN",
        "first_name": "EDITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A178017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.