Shahrouz Daniel Ganjian, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A113978 Issued in CA

Practice address

1821 Wilshire Blvd Ste 100
Santa Monica, CA 90403-5627

Phone

(310) 829-4403

NPI assigned

Aug 2, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Daniel Ganjian Professional name

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (1 of 2)

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Providence Saint Johns Medical Foundation

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734

  Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1249171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1457582934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035627",
            "telephone_number": "310-829-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 WILSHIRE BLVD STE 100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035627",
            "telephone_number": "310-829-4403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANJIAN",
        "first_name": "SHAHROUZ",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-02",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080B0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Obesity Medicine",
            "state": "CA",
            "license": "A113978",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A113978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "GANJIAN",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Game on App LLC
• Farinoush Gaminchi, D.M.D.
• Vipal Dinesh Gandhi, O.D.
• Roshen Ganesh, D.D.S.
• Kiran Gangadhar, MD
• Brian Randall Gantwerker, M.D.
• Yuqing Alexandria Gao, M.D.
• Alison C Garb
• Stuart H. Garber, D.C., PH.D.
• Mary Garbesi, MFT

• Pediatrics Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.