Individual provider Active NPI

Gary John Gevorkian, PHARM.D.

  • Pharmacist
  • Glendale, CA
National Provider Identifier
1083083083
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
72639 Issued in CA
Practice address
800 S Central Ave Ste 101a
Glendale, CA 91204-4375
Phone
(818) 853-2880
Fax
(818) 853-2881
NPI assigned
Sep 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 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 72639 CA Primary

Addresses

Primary practice location

800 S Central Ave Ste 101a
Glendale, CA 91204-4375

Mailing address

800 S Central Ave Ste 101a
Glendale, CA 91204-4375
Phone (818) 853-2880

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
72639CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
LGDM Current Accepting new patients
LGDM Current Accepting new patients
Thrifty Payless Inc Past Accepting new patients
Thrifty Payless Inc Past Accepting new patients

Locations

800 S Central Ave
Ste 101A
Glendale, CA 91204
Phone (818) 244-5152

Organizations & group practices 4

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": "1442707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1083083083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 101A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044375",
            "telephone_number": "818-853-2880",
            "fax_number": "818-853-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 101A",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044375",
            "telephone_number": "818-853-2880",
            "fax_number": "818-853-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEVORKIAN",
        "first_name": "GARY",
        "middle_name": "JOHN",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-20",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "72639",
            "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 Mar 8, 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.