Evsla Medical Corporation

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

EVSLA MEDICAL CORPORATION

Practice address

28049 Smyth Dr
Valencia, CA 91355-4023

Phone

(661) 705-9706

Fax

(661) 702-1701

NPI assigned

Jul 20, 2023

Organization subpart

No

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

Authorized official

Name

Harout Dermendjian, MDNPI 1689038424

Title

Owner

Phone

(323) 791-8918

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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.

• Harout Dermendjian, M.D.

  • Vascular & Interventional Radiology Physician
  • Valencia, CA
  • NPI 1689038424
  Medicare reassignment Care Compare group NPD Authorized official
• Kartik Kansagra

  • Vascular & Interventional Radiology Physician
  • Glendale, CA
  • NPI 1043604465

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Sipan Mathevosian, M.D.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1518499722

  Vascular & Interventional Radiology

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1477233898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28049 SMYTH DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554023",
            "telephone_number": "661-705-9706",
            "fax_number": "661-702-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28049 SMYTH DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554023",
            "telephone_number": "661-705-9706",
            "fax_number": "661-702-1701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1530 E Chevy Chase Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912064139",
            "country_code": "US",
            "telephone_number": "661-705-9706",
            "fax_number": "661-702-1701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVSLA MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "DERMENDJIAN",
        "authorized_official_first_name": "HAROUT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-791-8918",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Geanne Evans
• John Tyndal Evans, D.D.S.
• Tonjanae Evans
• Estelle Marla Everett, M.D.
• Evergreen Retina Inc a Professional Medical Corporation
• Danielle Ewing, RCSN
• Ezcor-9000 Inc. (ezcor medical supply)
• Ezzat Dental Corporation (Pediatric Dentistry of Valencia)
• Angela Ezzat, DDS
• Chris Ezzat, DDS

• Vascular & Interventional Radiology Physician in Valencia, CA
• Providers in Valencia, CA by specialty
• Vascular & Interventional Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.