Madatovian Medical Clinic, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A53748 Issued in CA

Legal business name

MADATOVIAN MEDICAL CLINIC, INC.

Practice address

501 W Glenoaks Blvd Ste 205
Glendale, CA 91202-4042

Phone

(818) 549-9630

Fax

(818) 549-9631

NPI assigned

Nov 29, 2010

Organization subpart

No

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

Authorized official

Name

Vahan Madatovian, M.D.NPI 1265650493

Title

Physician

Phone

(818) 549-9630

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Vahan Madatovian, MD

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1265650493
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1134421050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W GLENOAKS BLVD STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024042",
            "telephone_number": "818-549-9630",
            "fax_number": "818-549-9631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W GLENOAKS BLVD STE 205",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912024042",
            "telephone_number": "818-549-9630",
            "fax_number": "818-549-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADATOVIAN MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-29",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "MADATOVIAN",
        "authorized_official_first_name": "VAHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "818-549-9630",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A53748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Natalia Macias, PHARMD.
• Diana Grace Mack
• Roy-Carlo Maclang, D.P.T.
• Madanyan Enterprise
• Akop Sarkis Madanyan
• Vahan Madatovian, MD
• Barbara J Madden, MSW
• Megan Annette Maddock, PA-C
• Mado Home Health Care Inc
• Mado Hospice Inc

• Family Medicine Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; 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.