Alexander Evan Kertzner

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A187762 Issued in CA

Practice address

4323 W Riverside Dr
Burbank, CA 91505-4044

Phone

(818) 556-2700

Fax

(818) 295-3450

NPI assigned

Apr 1, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1083292684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "telephone_number": "310-301-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 W RIVERSIDE DR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054044",
            "telephone_number": "818-556-2700",
            "fax_number": "818-295-3450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18460 Roscoe Blvd",
            "address_purpose": "LOCATION",
            "city": "Northridge",
            "state": "CA",
            "postal_code": "913254107",
            "country_code": "US",
            "telephone_number": "818-993-5054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KERTZNER",
        "first_name": "ALEXANDER",
        "middle_name": "EVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A187762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanna Keloyan
• Brendan Kennedy
• Jennifer Keo
• Chantra Keobunta
• Varand Kerikorian, DDS
• David E Kesey, AMFT
• Keshishian Dental Inc a Professional Dental Corporation
• Arbi Keshishian
• Hermineh Keshishian, MSW
• Zohrab Shaunt Keshishian, MD

• Family Medicine Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.