Individual provider Active NPI

Rouben Barsegian

  • Clinical Medical Laboratory
  • Glendale, CA
National Provider Identifier
1235360777
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
B6617575 Issued in CA
Practice address
5242 San Fernando Rd
Glendale, CA 91203-2439
Phone
(818) 265-0001
Fax
(818) 265-0008
NPI assigned
Jul 31, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X B6617575 CA Primary

Addresses

Primary practice location

5242 San Fernando Rd
Glendale, CA 91203-2439

Mailing address

5242 San Fernando Rd
Glendale, CA 91203-2439
Phone (818) 265-0001

Other names 1

  • Dba Medex Laboratories Other name

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

State licenses

LicenseStateTypeSpecialty
B6617575CAMDClinical Medical Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1235360777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5242 SAN FERNANDO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032439",
            "telephone_number": "818-265-0001",
            "fax_number": "818-265-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5242 SAN FERNANDO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912032439",
            "telephone_number": "818-265-0001",
            "fax_number": "818-265-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARSEGIAN",
        "first_name": "ROUBEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "B6617575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DBA",
            "last_name": "LABORATORIES",
            "middle_name": "MEDEX",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 31, 2009; 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.