Individual provider Active NPI

Alex Semerjian

  • Contractor
  • Glendale, CA
National Provider Identifier
1073996203
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
PHOP1513182 Issued in CA
Practice address
724 Geneva St
Glendale, CA 91206-2122
Phone
(818) 424-3200
NPI assigned
Jul 7, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X PHOP1513182 CA Primary

Addresses

Primary practice location

724 Geneva St
Glendale, CA 91206-2122

Mailing address

724 Geneva St
Glendale, CA 91206-2122
Phone (818) 424-3200

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
PHOP1513182CAMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1073996203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "724 GENEVA ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062122",
            "telephone_number": "818-424-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 GENEVA ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912062122",
            "telephone_number": "818-424-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMERJIAN",
        "first_name": "ALEX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "CA",
            "license": "PHOP1513182",
            "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 Jul 7, 2015; 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.