Mary Demirjian, O.D., Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

13710 Issued in CA

Legal business name

MARY DEMIRJIAN, O.D., INC.

Practice address

17283 Ventura Blvd
Encino, CA 91316-4007

Phone

(818) 990-0300

Fax

(818) 990-4854

NPI assigned

Dec 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Mary Demirjian, O.D.NPI 1043449655

Title

President

Phone

(818) 990-0300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mary Demirjian, O.D.

  • Optometrist
  • Encino, CA
  • NPI 1043449655
  Medicare reassignment NPD Authorized official
• Hetavi Patel

  • Optometrist
  • Encino, CA
  • NPI 1346061918
  Medicare reassignment NPD
• Jennifer Ho, OD

  • Optometrist
  • Palmdale, CA
  • NPI 1003582339
  NPD (past)
• Mayra Carolina Lazo, OD

  • Optometrist
  • Reseda, CA
  • NPI 1023898566
  NPD (past)
• Beau Stapf Stocking, OD

  • Optometrist
  • Burbank, CA
  • NPI 1922092105
  NPD (past)
• Allen Benjamin Yeroushalmi, M.D.

  • Ophthalmology Physician
  • Beverly Hills, CA
  • NPI 1952562159
  NPD (past)

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1366744856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17283 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164007",
            "telephone_number": "818-990-0300",
            "fax_number": "818-990-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17283 VENTURA BLVD",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913164007",
            "telephone_number": "818-990-0300",
            "fax_number": "818-990-4854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24480 Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Santa Clarita",
            "state": "CA",
            "postal_code": "913212873",
            "country_code": "US",
            "telephone_number": "661-505-7133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "38024 47th St E Ste F",
            "address_purpose": "LOCATION",
            "city": "Palmdale",
            "state": "CA",
            "postal_code": "935523120",
            "country_code": "US",
            "telephone_number": "661-441-4455",
            "fax_number": "661-878-8677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARY DEMIRJIAN, O.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "DEMIRJIAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-990-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "13710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra Martinez
• Michael Jet Martinez
• Victor E Martinez
• Ani Martirosyan, BCBA
• Mary Ann Corpus Professional Dental Corporation
• Maryam Navab Dental Corporation
• Maryam Seddigh Tonekaboni, MD, Inc.
• Avital Marzini
• Shabnam Mashinchi
• Ilana Mashke, LMT

• Optometrist in Encino, CA
• Providers in Encino, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.