Organization Active NPI

Edwin Haronian, M D. Inc.

  • Specialist
  • Sherman Oaks, CA
National Provider Identifier
1104007483
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A71385 Issued in CA
Legal business name
EDWIN HARONIAN, M D. INC.
Practice address
5651 Sepulveda Blvd
Suite 201
Sherman Oaks, CA 91411-2916
Phone
(818) 788-2400
Fax
(818) 788-2453
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Dr. Edwin Haronian, M.D.NPI 1063480192
Title
President
Phone
(818) 788-2400

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X A71385 CA Primary

Addresses

Primary practice location

5651 Sepulveda Blvd
Suite 201
Sherman Oaks, CA 91411-2916

Mailing address

5651 Sepulveda Blvd
Suite 201
Sherman Oaks, CA 91411-2916
Phone (818) 788-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080430000710 CA Part B Supplier - Clinic/Group Practice 9234218348 Receives reassigned benefits from 1 practitioner
Practice locations: Pomona, CA; Sherman Oaks, CA

National Provider Directory

National Provider Directory

Locations

5651 Sepulveda Blvd
Ste 20
Sherman Oaks, CA 91411
Phone (818) 788-2400

Practitioners & affiliated clinicians

Practitioners 3

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": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1104007483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5651 SEPULVEDA BLVD",
            "address_2": "SUITE 201",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914112916",
            "telephone_number": "818-788-2400",
            "fax_number": "818-788-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5651 SEPULVEDA BLVD",
            "address_2": "SUITE 201",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914112916",
            "telephone_number": "818-788-2400",
            "fax_number": "818-788-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWIN HARONIAN, M D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "HARONIAN",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-788-2400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A71385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.