NPIMap

Organization Active NPI

Verdugo Multi-Specialty Medical Group, Inc.

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1487869533
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A91884 Issued in CA
Legal business name
VERDUGO MULTI-SPECIALTY MEDICAL GROUP, INC.
Practice address
819 S Vermont Ave
Los Angeles, CA 90005-1522
Phone
(323) 928-5052
Fax
(323) 274-4604
NPI assigned
May 11, 2007
Last updated
Jan 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Authorized official

Name
Aram Manoukyan
Title
Ceo
Phone
(323) 255-5818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A91884 CA Primary

Addresses

Primary practice location

819 S Vermont Ave
Los Angeles, CA 90005-1522

Mailing address

819 S Vermont Ave
Los Angeles, CA 90005-1522
Phone (323) 928-5052

Other identifiers 1

IdentifierTypeStateIssuer
1487869533MedicaidCA

National Provider Directory

National Provider Directory

Locations

2607 Mount Vernon Ave
Bakersfield, CA 93306
Phone (661) 871-8133

2603 Mount Vernon Ave
Bakersfield, CA 93306
Phone (661) 871-5892

4139 Verdugo Rd
Los Angeles, CA 90065
Phone (323) 255-5818

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1487869533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051522",
            "telephone_number": "323-928-5052",
            "fax_number": "323-274-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 S VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900051522",
            "telephone_number": "323-928-5052",
            "fax_number": "323-274-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERDUGO MULTI-SPECIALTY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "MANOUKYAN",
        "authorized_official_first_name": "ARAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-255-5818"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A91884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487869533",
            "state": "CA"
        }
    ],
    "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 Jan 13, 2016; 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.