Individual provider Active NPI

Ryan Yeghoian, PHARMD

  • Pharmacist
  • Glendale, CA
National Provider Identifier
1053068460
Registry record updated Mar 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
85737 Issued in CA
Practice address
1851 Flower St
Glendale, CA 91201-2024
Phone
(747) 286-2141
NPI assigned
Mar 5, 2022
Last updated
Mar 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 85737 CA Primary

Addresses

Primary practice location

1851 Flower St
Glendale, CA 91201-2024

Mailing address

10160 Eldora Ave
Sunland, CA 91040-3217
Phone (818) 471-9103

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
85737CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Accumed Inc CurrentSince Jun 23, 2024 Accepting new patients
Accumed Inc CurrentSince Mar 13, 2022 Accepting new patients

Locations

1851 Flower St
Glendale, CA 91201
Phone (747) 286-2141

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1646438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646438400000",
    "number": "1053068460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10160 ELDORA AVE",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910403217",
            "telephone_number": "818-471-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 FLOWER ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912012024",
            "telephone_number": "747-286-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEGHOIAN",
        "first_name": "RYAN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-05",
        "last_updated": "2022-03-05",
        "certification_date": "2022-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "85737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "1851 Flower St",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912012024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 5, 2022; 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.