Interventional Spine Care & Orthopedic Regenerative Experts

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

118692 Issued in CA

Legal business name

INTERVENTIONAL SPINE CARE & ORTHOPEDIC REGENERATIVE EXPERTS

Practice address

800 S Central Ave Ste 301
Glendale, CA 91204-4388

Phone

(818) 338-6860

Fax

(888) 425-9079

NPI assigned

Oct 18, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Maxim Moradian, M.D.NPI 1497924864

Title

Owner/President

Phone

(818) 913-9356

Specialties & licenses 3

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Maxim Moradian, M.D.

  • Interventional Pain Medicine Physician
  • Glendale, CA
  • NPI 1497924864
  Authorized official Same address or phone

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1427509033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8232",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912240232",
            "telephone_number": "818-913-9356",
            "fax_number": "818-369-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044388",
            "telephone_number": "818-338-6860",
            "fax_number": "888-425-9079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "51 N 5th Ave Ste 301",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910063712",
            "country_code": "US",
            "telephone_number": "818-338-6860",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Central Ave",
            "address_2": "SUITE 101",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912042530",
            "country_code": "US",
            "telephone_number": "818-913-9356",
            "fax_number": "818-369-7177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE CARE & ORTHOPEDIC REGENERATIVE EXPERTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "MORADIAN",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "818-913-9356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "118692",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "118692",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A118692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.