Individual provider Active NPI

Henry Ian Haruthunian, DO

  • Sports Medicine (Family Medicine) Physician
  • Northridge, CA
National Provider Identifier
1235873191
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
20A21541 Issued in CA
Practice address
18460 Roscoe Blvd
Northridge, CA 91325-4107
Phone
(818) 885-5480
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Sports Medicine (Family Medicine) Physician 207QS0010X 20A21541 CA Primary

Addresses

Primary practice location

18460 Roscoe Blvd
Northridge, CA 91325-4107

Mailing address

18460 Roscoe Blvd
Northridge, CA 91325-4107

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250327000302 CA Order and Referring Only - Osteopathic Manipulative MedicinePractitioner - Osteopathic Manipulative Medicine 3476074071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Central Coast Health Centers Past Accepting new patients

Organizations & group practices 1

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": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1235873191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18460 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18460 ROSCOE BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107",
            "telephone_number": "818-885-5480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARUTHUNIAN",
        "first_name": "HENRY",
        "middle_name": "IAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "20A21541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.