Active NPI
Hakop Khurdajian, O.D.
- Optometrist
- Los Angeles, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPT33511-TLG
- Practice address
- 1843 S la Cienega Blvd
Los Angeles, CA 90035-4603 - Phone
- (800) 954-8000
- NPI assigned
- Apr 2, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Low Vision Rehabilitation Optometrist | 152WL0500X | OPT33511-TLF | CA | |
| Low Vision Rehabilitation Optometrist | 152WL0500X | OPT33511-TLG | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Optometrist | 152W00000X | OPT33511-TLG | CA | Primary |
Addresses
Primary practice location
1843 S la Cienega Blvd
Los Angeles, CA 90035-4603
Mailing address
1843 1/2 S la Cienega Blvd
Los Angeles, CA 90035-4603
Other practice location 1
351 E Temple St
Los Angeles, CA 90012-3328
Phone (213) 253-2677
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of California - School of Optometry, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1843 /2 S la Cienega Blvd
Los Angeles, CA 90035-4603
Phone (323) 857-2673
6041 Cadillac Ave
Los Angeles, CA 90034-1702
Phone (800) 954-8000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPT33511-TLG | CA | MD | Optometrist |
| OPT33511-TLF | CA | MD | Low Vision Rehabilitation Optometrist |
| 33511 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Multi-Specialty | Current | Accepting new patients |
Locations
6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000
1843 S La Cienega Blvd
Los Angeles, CA 90035
Phone (310) 558-0373
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
Organizations & group practices 3
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.
-
- Health Maintenance Organization
- Baldwin Park, CA
- NPI 1770515280
Multi-Specialty
-
- Health Maintenance Organization
- Los Angeles, CA
- NPI 1043242563
-
- Health Maintenance Organization
- Santa Clarita, CA
- NPI 1316409410
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635379200000",
"number": "1376906784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1843 1/2 S LA CIENEGA BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900354603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1843 S LA CIENEGA BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900354603",
"telephone_number": "800-954-8000"
}
],
"practiceLocations": [
{
"address_1": "351 E Temple St",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900123328",
"country_code": "US",
"telephone_number": "213-253-2677",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHURDAJIAN",
"first_name": "HAKOP",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-02",
"last_updated": "2021-10-28",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "152WL0500X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "CA",
"license": "OPT33511-TLF",
"primary": false
},
{
"code": "152WL0500X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "CA",
"license": "OPT33511-TLG",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": "CA",
"license": "OPT33511-TLG",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "6041 Cadillac Ave",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900341702",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.