Active NPI
Garo H Kodjababian, MD
- Anesthesiology Physician
- Downey, CA
National Provider Identifier
1407921646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A21436
- Practice address
- 11500 Brookshire Ave
Downey, CA 90241 - Phone
- (562) 904-5392
- Fax
- (562) 904-5385
- NPI assigned
- Nov 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A21436 | CA | Primary |
Addresses
Primary practice location
11500 Brookshire Ave
Downey, CA 90241
Mailing address
7706 Vale Drive
Whittier, CA 90602
Phone (562) 693-4160
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A214360 | Other | CA | BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407921646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7706 VALE DRIVE",
"city": "WHITTIER",
"state": "CA",
"postal_code": "90602",
"telephone_number": "562-693-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11500 BROOKSHIRE AVE",
"city": "DOWNEY",
"state": "CA",
"postal_code": "90241",
"telephone_number": "562-904-5392",
"fax_number": "562-904-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODJABABIAN",
"first_name": "GARO",
"middle_name": "H",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A21436",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00A214360",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Downey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.