Active NPI
Jonathan Mkrtchyan
- Student in an Organized Health Care Education/Training Program
- Los Angeles, CA
National Provider Identifier
1568263549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 2051 Marengo St Clinic Tower Suite A7D
Los Angeles, CA 90089-1001 - Phone
- (818) 389-7567
- NPI assigned
- Mar 24, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
2051 Marengo St Clinic Tower Suite A7D
Los Angeles, CA 90089-1001
Mailing address
1135 Linden Ave Apt 107
Glendale, CA 91201-3358
Phone (818) 389-7567
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250815000349 | CA | Order and Referring Only - Emergency Medicine | 5193224368 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1568263549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1135 LINDEN AVE APT 107",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912013358",
"telephone_number": "818-389-7567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2051 MARENGO ST CLINIC TOWER SUITE A7D",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900891001",
"telephone_number": "818-389-7567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MKRTCHYAN",
"first_name": "JONATHAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-24",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"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 Jun 24, 2025; 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.