Individual provider Active NPI

Gegam D Bejanian

  • Non-emergency Medical Transport (VAN)
  • Glendale, CA
National Provider Identifier
1053650440
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
CVOP1226556 Issued in CA
Practice address
1153 N Brand Blvd Ste 103
Glendale, CA 91202-2503
Phone
(818) 242-3644
NPI assigned
Feb 5, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X CVOP1226556 CA Primary

Addresses

Primary practice location

1153 N Brand Blvd Ste 103
Glendale, CA 91202-2503

Mailing address

1153 N Brand Blvd Ste 103
Glendale, CA 91202-2503
Phone (818) 242-3644

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

State licenses

LicenseStateTypeSpecialty
CVOP1226556CAMDNon-emergency Medical Transport (VAN)

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Med-Ride Medical Transportation Non-Emergency Medical Transport (Van) CurrentSince Jan 10, 2021 Accepting new patients

Locations

1153 N Brand Blvd
Ste 103
Glendale, CA 91202
Phone (818) 242-3644

Organizations & group practices 1

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": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1053650440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 N BRAND BLVD STE 103",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022503",
            "telephone_number": "818-242-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 N BRAND BLVD STE 103",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022503",
            "telephone_number": "818-242-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEJANIAN",
        "first_name": "GEGAM",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-05",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": "CVOP1226556",
            "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 Jan 8, 2021; 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.