California Surgical Multi-Specialty Group Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A92473 Issued in CA

Legal business name

CALIFORNIA SURGICAL MULTI-SPECIALTY GROUP INC.

Practice address

800 S Central Ave
212
Glendale, CA 91204-4370

Phone

(818) 247-2000

Fax

(818) 247-2121

NPI assigned

Nov 8, 2012

Organization subpart

No

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

Authorized official

Name

Gevorg Mutafyan, M.D.NPI 1255465506

Title

Medical Director

Phone

(818) 247-2000

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.

• Gevorg Arutyunavich Mutafyan, MD

  • Surgery Physician
  • Glendale, CA
  • NPI 1255465506
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1144574484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE",
            "address_2": "212",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-247-2000",
            "fax_number": "818-247-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE",
            "address_2": "212",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-247-2000",
            "fax_number": "818-247-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA SURGICAL MULTI-SPECIALTY GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "MUTAFYAN",
        "authorized_official_first_name": "GEVORG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-247-2000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A92473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.