Shahan Yacoubian Medical Corporation

Primary specialty

Adult Reconstructive Orthopaedic Surgery PhysicianTaxonomy code 207XS0114X

License

A95385 Issued in CA

Legal business name

SHAHAN YACOUBIAN MEDICAL CORPORATION

Practice address

2625 W Alameda Ave Ste 116
Burbank, CA 91505-4815

Phone

(818) 841-3936

Fax

(818) 841-5974

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Shahan V Yacoubian, M.D.

Title

President

Phone

(818) 841-3936

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1336247238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE STE 116",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054815",
            "telephone_number": "818-841-3936",
            "fax_number": "818-841-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 W ALAMEDA AVE STE 116",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054815",
            "telephone_number": "818-841-3936",
            "fax_number": "818-841-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHAN YACOUBIAN MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "YACOUBIAN",
        "authorized_official_first_name": "SHAHAN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-841-3936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "CA",
            "license": "A95385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A953850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Reconstructive Orthopaedic Surgery Physician in Burbank, CA
• Providers in Burbank, CA by specialty
• Adult Reconstructive Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.