Individual provider Active NPI

Siranush Miduryan, PHARMD

  • Pharmacist
  • Glendale, CA
National Provider Identifier
1184357717
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
67679 Issued in CA
Practice address
1200 S Central Ave
Glendale, CA 91204-2504
Phone
(818) 240-7152
NPI assigned
Jul 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 67679 CA Primary

Addresses

Primary practice location

1200 S Central Ave
Glendale, CA 91204-2504

Mailing address

1200 S Central Ave
Glendale, CA 91204-2504

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
67679CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Sirmid, Inc Current Accepting new patients
Sirmid, Inc Current Accepting new patients
Hye Pharmacy Inc PastSince Jul 17, 2022 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1184357717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042504",
            "telephone_number": "818-240-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDURYAN",
        "first_name": "SIRANUSH",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "67679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.