Mirna Demirdjian, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

C162232 Issued in CA

Practice address

2501 E Chapman Ave Ste 107
Fullerton, CA 92831-3135

Phone

(714) 409-6881

Fax

(480) 422-8886

NPI assigned

Jul 9, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Obstetrics/Gynecology

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: mdemirdjian852685@direct.memorialcare.org

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.

• Valley Womens Care Apc

  • Obstetrics & Gynecology Physician
  • Fullerton, CA
  • NPI 1366797581
  Medicare reassignment NPD Authorized official
• Enloe Medical Center

  • Obstetrics & Gynecology Physician
  • Chico, CA
  • NPI 1023420726
  Medicare reassignment NPD
• Enloe Medical Center

  • Surgery Physician
  • Chico, CA
  • NPI 1477975613
  Medicare reassignment NPD
• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD
• Enloe Medical Center

  • Community/Retail Pharmacy
  • Chico, CA
  • NPI 1912949538
  NPD
• Anaheim Memorial Medical Center

  • General Acute Care Hospital
  • Anaheim, CA
  • NPI 1295782381
  NPD (past)
• Banner Desert Medical Center

  • Skilled Nursing Facility
  • Mesa, AZ
  • NPI 1780739631
  NPD (past)
• Momdoc, LLC

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
  • NPI 1184780355
  NPD (past)

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1407085665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8064 DORADO CIR",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081969",
            "telephone_number": "714-409-6881",
            "fax_number": "480-422-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E CHAPMAN AVE STE 107",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313135",
            "telephone_number": "714-409-6881",
            "fax_number": "480-422-8886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2034 S Alma School Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852104024",
            "country_code": "US",
            "telephone_number": "480-426-0200",
            "fax_number": "480-422-8886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMIRDJIAN",
        "first_name": "MIRNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "42234",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "C162232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "440426",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Guadalupe Delgado
• Noel Delgado
• Jeffrey Dell, M.D.
• Ryo Delu
• Adrianna Delvasto
• Philip John Demman, MD
• Dennis Williams MFT
• Jon Densing, PT, DPT
• Karen M Depaoli, DDS
• Sophia Depumpo

• Obstetrics & Gynecology Physician in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 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.

Verify at the official NPI Registry.