Individual provider Active NPI

Lusine Simonyan, ND

  • Adult Medicine Physician
  • Glendale, CA
National Provider Identifier
1063293215
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
1454 Issued in CA
Practice address
116 N Artsakh Ave Ste 120
Glendale, CA 91206-4771
Phone
(818) 484-5471
Fax
(818) 649-5632
NPI assigned
Oct 12, 2023
Last updated
Oct 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 1454 CA
Adult Medicine Physician 207QA0505X 1454 CA Primary

Addresses

Primary practice location

116 N Artsakh Ave Ste 120
Glendale, CA 91206-4771

Mailing address

116 N Artsakh Ave Ste 120
Glendale, CA 91206-4771
Phone (818) 484-5471

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
1454CAMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1063293215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N ARTSAKH AVE STE 120",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064771",
            "telephone_number": "818-484-5471",
            "fax_number": "818-649-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N ARTSAKH AVE STE 120",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064771",
            "telephone_number": "818-484-5471",
            "fax_number": "818-649-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONYAN",
        "first_name": "LUSINE",
        "credential": "ND",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CA",
            "license": "1454",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "1454",
            "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 Oct 12, 2023; 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.