Individual provider Active NPI

Robert Magnus Vartazarov, FNP

  • Family Nurse Practitioner
  • Murrieta, CA
National Provider Identifier
1124955901
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95037481 Issued in CA
Practice address
34791 Serissa CT
Murrieta, CA 92563-1123
Phone
(951) 234-1911
NPI assigned
May 6, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X 95281585 CA
Rehabilitation Registered Nurse 163WR0400X 95281585 CA
Family Nurse Practitioner 363LF0000X 95037481 CA Primary

Addresses

Primary practice location

34791 Serissa CT
Murrieta, CA 92563-1123

Mailing address

34791 Serissa CT
Murrieta, CA 92563-1123

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

State licenses

LicenseStateTypeSpecialty
95281585CAMDRehabilitation Registered Nurse
95037481CAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1778025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1124955901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34791 SERISSA CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34791 SERISSA CT",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925631123",
            "telephone_number": "951-234-1911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARTAZAROV",
        "first_name": "ROBERT",
        "middle_name": "MAGNUS",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-06",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "CA",
            "license": "95281585",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "CA",
            "license": "95281585",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95037481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.