Active NPI
Petros Taglyan
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1457099103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 39610
- Practice address
- 5236 Santa Monica Blvd
Los Angeles, CA 90029-1210 - Phone
- (323) 661-7152
- NPI assigned
- May 23, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 39610 | CA | Primary |
Addresses
Primary practice location
5236 Santa Monica Blvd
Los Angeles, CA 90029-1210
Mailing address
5236 Santa Monica Blvd
Los Angeles, CA 90029-1210
Phone (323) 661-7152
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39610 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653264000000",
"number": "1457099103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5236 SANTA MONICA BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900291210",
"telephone_number": "323-661-7152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5236 SANTA MONICA BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900291210",
"telephone_number": "323-661-7152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAGLYAN",
"first_name": "PETROS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-05-23",
"last_updated": "2022-05-23",
"certification_date": "2022-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "CA",
"license": "39610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.