Individual provider Active NPI

Hratch Demirjian, D.P.M.

  • Podiatrist
  • Covina, CA
National Provider Identifier
1265440366
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3993 Issued in CA
Practice address
1257 W San Bernardino Rd
Covina, CA 91722-3509
Phone
(626) 331-7391
Fax
(626) 339-0613
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3993 CA Primary

Addresses

Primary practice location

1257 W San Bernardino Rd
Covina, CA 91722-3509

Mailing address

PO Box 1980
Covina, CA 91722-0980
Phone (626) 331-7391

Other identifiers 1

IdentifierTypeStateIssuer
00039930MedicaidCA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101110000411 CA Practitioner - Podiatry 5698960185 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians of Southern California IncGroup PAC ID 8123435658, 7 clinicians

Practice addresses (Care Compare)

1257 W San Bernardino Rd
Covina, CA 91722-3509
Phone (626) 331-7391

3235 E Colorado Blvd
Suite 102
Pasadena, CA 91107-3838
Phone (626) 859-2249

Hospital & facility affiliations

  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue114
Removal of skin lesions1-10
Removal of nail tissue529
Removal or shaving of skin growth533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3993CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hara Podiatrists' Group, Inc. Podiatrist CurrentSince Aug 10, 2010 Accepting new patients
Physicians of Southern California Inc CurrentSince Feb 14, 2025 Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients

Locations

1257 W San Bernardino Rd
Covina, CA 91722
Phone (626) 331-7391

1624 S Grand Ave
Glendora, CA 91740
Phone (626) 859-2249

1304 W Holt Blvd
Ste A
Ontario, CA 91762
Phone (626) 859-2249

3235 E Colorado Blvd
Ste 102
Pasadena, CA 91107
Phone (626) 859-2249

3235 E Colorado Blvd
Pasadena, CA 91107

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1265440366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1980",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917220980",
            "telephone_number": "626-331-7391",
            "fax_number": "626-339-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 W SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223509",
            "telephone_number": "626-331-7391",
            "fax_number": "626-339-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMIRJIAN",
        "first_name": "HRATCH",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00039930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.