Organization Active NPI

Allergy and Asthma Treatment Center P C

  • Allergy & Immunology Physician
  • Glendale, CA
National Provider Identifier
1225467590
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
A111311 Issued in CA
Legal business name
ALLERGY AND ASTHMA TREATMENT CENTER P C
Practice address
1131 N Pacific Ave
Glendale, CA 91202-2358
Phone
(818) 558-5828
Fax
(888) 717-1542
NPI assigned
Nov 6, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
Dr. Marine Demirjian, M.D.NPI 1669624219
Title
President
Phone
(818) 558-5828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X A111311 CA Primary

Addresses

Primary practice location

1131 N Pacific Ave
Glendale, CA 91202-2358

Mailing address

1131 N Pacific Ave
Glendale, CA 91202-2358
Phone (818) 558-5828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140324000527 CA Part B Supplier - Clinic/Group Practice 8022249762 Receives reassigned benefits from 4 practitioners
Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Locations

435 N Glenoaks Blvd
Burbank, CA 91502
Phone (818) 558-5828

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1383696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1225467590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 N PACIFIC AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022358",
            "telephone_number": "818-558-5828",
            "fax_number": "888-717-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N PACIFIC AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022358",
            "telephone_number": "818-558-5828",
            "fax_number": "888-717-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY AND ASTHMA TREATMENT CENTER P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-06",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "DEMIRJIAN",
        "authorized_official_first_name": "MARINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-558-5828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "A111311",
            "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 Jan 13, 2023; 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.