Organization Active NPI

Vardui Arutyunyan-MD Inc

  • Primary Care Clinic/Center
  • Glendale, CA
National Provider Identifier
1235577982
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A70072 Issued in CA
Legal business name
VARDUI ARUTYUNYAN-MD INC
Practice address
1030 S Glendale Ave
309
Glendale, CA 91205-5612
Phone
(818) 553-1020
Fax
(818) 553-6651
NPI assigned
Jun 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Dr. Vardui Arutyunyan, M.D.NPI 1841235223
Title
Owner
Phone
(818) 553-1020

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
Primary Care Clinic/Center 261QP2300X A70072 CA Primary

Addresses

Primary practice location

1030 S Glendale Ave
309
Glendale, CA 91205-5612

Mailing address

1030 S Glendale Ave
309
Glendale, CA 91205-5612
Phone (818) 553-1020

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131209000050 CA Part B Supplier - Clinic/Group Practice 9931336443 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1007639Vardui Arutyunyan, MD Inc1030 S Glendale Ave Ste 308, Glendale, CA 91205Certificate of waiverDec 23, 2026

National Provider Directory

National Provider Directory

Locations

1030 S Glendale Ave
Ste 309
Glendale, CA 91205
Phone (818) 553-1020

Practitioners & affiliated clinicians

Practitioners 1

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": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1235577982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE",
            "address_2": "309",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912055612",
            "telephone_number": "818-553-1020",
            "fax_number": "818-553-6651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE AVE",
            "address_2": "309",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912055612",
            "telephone_number": "818-553-1020",
            "fax_number": "818-553-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARDUI ARUTYUNYAN-MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-04",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "ARUTYUNYAN",
        "authorized_official_first_name": "VARDUI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-553-1020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A70072",
            "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 Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.