NPIMap

Individual provider Active NPI

Mardiros H Mihranian, M.D.

  • Surgery Physician
  • Glendale, CA
National Provider Identifier
1093997330
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A30059 Issued in CA
Practice address
330 N Brand Blvd Ste 190
Glendale, CA 91203-4425
Phone
(818) 240-1820
Fax
(818) 240-1021
NPI assigned
Nov 28, 2007
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A30059 CA Primary

Addresses

Primary practice location

330 N Brand Blvd Ste 190
Glendale, CA 91203-4425

Mailing address

330 N Brand Blvd Ste 190
Glendale, CA 91203-4425
Phone (818) 240-1820

Other identifiers 1

IdentifierTypeStateIssuer
00A300590MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080519000809 CA Practitioner - General Surgery 0042396939 Reassigns benefits to 2 organizations
Practice locations: Glendale, CA

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

330 N Brand Blvd
Suite 190
Glendale, CA 91203-4425
Phone (818) 240-1820

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30059CAMDGeneral Practice Dentistry
A30059CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avalon Wound Care Inc CurrentSince Dec 1, 2024 Accepting new patients
Dignity Health Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Medical Clinic and Surgical Specialties of Glendale Surgery Past Accepting new patients

Locations

4001 W Alameda Ave
Ste 100
Burbank, CA 91505
Phone (818) 419-8080

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mardirosmihranian.137.314@securemailmdscloud.mdsynergy.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bonum Home Health ServicesBurbank, CA, CCN 059076 Home health agency Contracted Managing Employee Jun 1, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1093997330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N BRAND BLVD STE 190",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034425",
            "telephone_number": "818-240-1820",
            "fax_number": "818-240-1021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N BRAND BLVD STE 190",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034425",
            "telephone_number": "818-240-1820",
            "fax_number": "818-240-1021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIHRANIAN",
        "first_name": "MARDIROS",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-28",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A30059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A300590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.