Individual provider Active NPI

Andre Nazarian, REGISTERED NURSE

  • General Practice Registered Nurse
  • Van Nuys, CA
National Provider Identifier
1295447761
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
95088454 Issued in CA
Practice address
7515 Van Nuys Blvd
Van Nuys, CA 91405-1949
Phone
(818) 627-3000
NPI assigned
Dec 15, 2022
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 95088454 CA Primary

Addresses

Primary practice location

7515 Van Nuys Blvd
Van Nuys, CA 91405-1949

Mailing address

3813 Sky View LN
Glendale, CA 91214-1006
Phone (818) 439-4232

Other identifiers 1

IdentifierTypeStateIssuer
95088454OtherCAREGISTERED NURSE

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
95088454CAMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1295447761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3813 SKY VIEW LN",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912141006",
            "telephone_number": "818-439-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 VAN NUYS BLVD",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051949",
            "telephone_number": "818-627-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARIAN",
        "first_name": "ANDRE",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "CA",
            "license": "95088454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "95088454",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.