Individual provider Active NPI

Galust Gary Halajyan, MD

  • Pediatric Anesthesiology Physician
  • Moreno Valley, CA
National Provider Identifier
1629161385
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
A69068 Issued in CA
Practice address
26520 Cactus Ave
Room #F 2027
Moreno Valley, CA 92555-3927
Phone
(951) 486-4000
NPI assigned
Oct 2, 2006
Last updated
May 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X A69068 CA Primary

Addresses

Primary practice location

26520 Cactus Ave
Room #F 2027
Moreno Valley, CA 92555-3927

Mailing address

PO Box 2757
Orange, CA 92859-0757
Phone (714) 973-2650

Other identifiers 2

IdentifierTypeStateIssuer
00A690680MedicaidCA
00A690680 F91OtherCACAL OPTIMA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000846 CA Practitioner - Anesthesiology 8729042213 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Caresway IncGroup PAC ID 2062894348, 2 clinicians

Practice addresses (Care Compare)

800 S Central Ave
Suite 207
Glendale, CA 91204-4388
Phone (747) 215-6998

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions126
Removal or shaving of skin growth76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A69068CAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Aug 24, 2013 Accepting new patients
County of Los Angeles CurrentSince Aug 24, 2013 Accepting new patients
Caresway Inc CurrentSince Jan 4, 2024 Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

7601 Imperial Hwy
Downey, CA 90242
Phone (310) 940-8111

800 S Central Ave
Ste 207
Glendale, CA 91204
Phone (747) 215-6998

12021 Wilmington Ave
Los Angeles, CA 90059
Phone (310) 668-4515

12021 Wilmington Ave
Rm 1059
Los Angeles, CA 90059
Phone (310) 668-5201

1670 E 120th St
Los Angeles, CA 90059
Phone (424) 338-1000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1629161385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2757",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928590757",
            "telephone_number": "714-973-2650",
            "fax_number": "714-973-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26520 CACTUS AVE",
            "address_2": "ROOM #F 2027",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925553927",
            "telephone_number": "951-486-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALAJYAN",
        "first_name": "GALUST",
        "middle_name": "GARY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "CA",
            "license": "A69068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A690680",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAL OPTIMA",
            "identifier": "00A690680 F91",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

Verify at the official NPI Registry.