Organization Active NPI

Orthopaedic Surgery Specialists Burbank

  • Physical Medicine & Rehabilitation Physician
  • Glendale, CA
National Provider Identifier
1053939546
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
ORTHOPAEDIC SURGERY SPECIALISTS BURBANK
Practice address
1300 S Central Ave
Glendale, CA 91204-2506
Phone
(818) 579-2395
Fax
(818) 579-2396
NPI assigned
Jul 10, 2020
Organization subpart
Yes
Parent organization
ORTHOPAEDIC SURGERY SPECIALISTS BURBANKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Authorized official

Name
Shahan Vahe Yacoubian, MD
Title
Director/Officer
Phone
(818) 841-3936

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Hand Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XH1200X

Addresses

Primary practice location

1300 S Central Ave
Glendale, CA 91204-2506

Mailing address

2625 W Alameda Ave Ste 116
Burbank, CA 91505-4815
Phone (818) 841-3936

National Provider Directory

National Provider Directory
Part of
Orthopaedic Surgery Spec

NPI Registry JSON

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

{
    "created_epoch": "1594339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1053939546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE STE 116",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054815",
            "telephone_number": "818-841-3936",
            "fax_number": "818-841-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042506",
            "telephone_number": "818-579-2395",
            "fax_number": "818-579-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC SURGERY SPECIALISTS BURBANK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOPAEDIC SURGERY SPECIALISTS BURBANK",
        "enumeration_date": "2020-07-10",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "YACOUBIAN",
        "authorized_official_first_name": "SHAHAN",
        "authorized_official_middle_name": "VAHE",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "818-841-3936",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Jul 10, 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.