Edwin Khachatourians, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA64707 Issued in CA

Practice address

1030 S Glendale Ave
Ste 402
Glendale, CA 91205

Phone

(818) 230-6522

NPI assigned

Jul 23, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

New York College of Osteo Medicine of New York Institute of Technology, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edward Samourjian Medical Corporation IncGroup PAC ID 0143696971, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edward Samourjian Medical Corporation, Inc.

  • Vascular Surgery Physician
  • Glendale, CA
  • NPI 1508593617
  Medicare reassignment Care Compare group
• Gynecologic Oncology Care, a Medical Corporation

  • Gynecologic Oncology Physician
  • Glendale, CA
  • NPI 1396684692
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Glendale Adventist Medical Center

  dba Adventist Health Glendale

  • General Acute Care Hospital
  • Glendale, CA
  • NPI 1831188275
  Care Compare affiliation

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1174351050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8285",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913278285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE",
            "address_2": "STE 402",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-230-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHACHATOURIANS",
        "first_name": "EDWIN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-23",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA64707",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA64707",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA64707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary K. Kevorkian, D.D.S., M.S.
• Nicole Keyllian
• Narbeh Khachatoorian, PHARMD
• Ani Khachatoorians, PT, DPT
• Christ Khachatourians
• Mariam Noemi Khachatrian, DDS
• Edgar Albertovich Khachatryan
• Elba Albertovna Khachatryan
• Hakob Khachatryan, DPT
• Hamlet Khachatryan

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.