NPIMap

Organization Active NPI

Adrine Yadegarian, M.D., a Medical Corporation

  • Pediatrics Physician
  • Glendale, CA
National Provider Identifier
1093129785
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A117160 Issued in CA
Legal business name
ADRINE YADEGARIAN, M.D., A MEDICAL CORPORATION
Practice address
411 N Central Ave
#130
Glendale, CA 91203-2081
Phone
(818) 550-1965
Fax
(818) 550-1966
NPI assigned
Jun 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Authorized official

Name
Dr. Adrine Yadegarian, M.D.NPI 1073875209
Title
President/Owner
Phone
(818) 550-1965

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A117160 CA Primary

Addresses

Primary practice location

411 N Central Ave
#130
Glendale, CA 91203-2081

Mailing address

411 N Central Ave
#130
Glendale, CA 91203-2081
Phone (818) 550-1965

National Provider Directory

National Provider Directory

Locations

411 N Central Ave
Ste 130
Glendale, CA 91203
Phone (818) 240-8767

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1093129785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 N CENTRAL AVE",
            "address_2": "#130",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032081",
            "telephone_number": "818-550-1965",
            "fax_number": "818-550-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N CENTRAL AVE",
            "address_2": "#130",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032081",
            "telephone_number": "818-550-1965",
            "fax_number": "818-550-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRINE YADEGARIAN, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-20",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "YADEGARIAN",
        "authorized_official_first_name": "ADRINE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "818-550-1965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A117160",
            "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 Feb 6, 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.