Organization Active NPI

West Coast Doctors Medical Group

  • Family Medicine Physician
  • Glendale, CA
National Provider Identifier
1467648329
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A72468 Issued in CA
Legal business name
WEST COAST DOCTORS MEDICAL GROUP
Practice address
814 E Broadway # 1
Glendale, CA 91205-1218
Phone
(818) 265-5040
Fax
(818) 242-1411
NPI assigned
Sep 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Narine ArutyounianNPI 1841248309
Title
President
Phone
(818) 265-5040

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A72468 CA Primary

Addresses

Primary practice location

814 E Broadway # 1
Glendale, CA 91205-1218

Mailing address

814 E Broadway # 1
Glendale, CA 91205-1218
Phone (818) 265-5040

Other identifiers 1

IdentifierTypeStateIssuer
00A724680MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050725000593 CA Part B Supplier - Clinic/Group Practice 2466489133 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1014667West Coast Doctors Medical Group Inc814 E Broadway, Ste #1, Glendale, CA 91205Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Locations

814 E Broadway
Ste 1
Glendale, CA 91205
Phone (818) 265-5040

801 S Chevy Chase Dr
Ste 104
Glendale, CA 91205
Phone (808) 265-2243

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1467648329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 E BROADWAY # 1",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051218",
            "telephone_number": "818-265-5040",
            "fax_number": "818-242-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 E BROADWAY # 1",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051218",
            "telephone_number": "818-265-5040",
            "fax_number": "818-242-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST COAST DOCTORS MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "ARUTYOUNIAN",
        "authorized_official_first_name": "NARINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-265-5040"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A72468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A724680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.