Individual provider Active NPI

Katherine Cosette Gyurdzhyan

  • Pharmacist
  • Los Angeles, CA
National Provider Identifier
1114795614
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
88869 Issued in CA
Practice address
4867 W Sunset Blvd
Los Angeles, CA 90027-5969
Phone
(323) 783-4011
NPI assigned
Dec 13, 2023
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 88869 CA Primary

Addresses

Primary practice location

4867 W Sunset Blvd
Los Angeles, CA 90027-5969

Mailing address

16006 Bassett St
Van Nuys, CA 91406-4805
Phone (323) 493-0462

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

NPI Registry JSON

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

{
    "created_epoch": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1114795614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16006 BASSETT ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064805",
            "telephone_number": "323-493-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 W SUNSET BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900275969",
            "telephone_number": "323-783-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GYURDZHYAN",
        "first_name": "KATHERINE",
        "middle_name": "COSETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "88869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.