Organization Active NPI

Kevin G. Galstyan M.D., Inc

  • Obstetrics & Gynecology Physician
  • Glendale, CA
National Provider Identifier
1649292715
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A87868 Issued in CA
Legal business name
KEVIN G. GALSTYAN M.D., INC
Practice address
222 W Eulalia St
211
Glendale, CA 91204-2849
Phone
(818) 502-4567
Fax
(818) 502-4568
NPI assigned
Jul 24, 2006
Last updated
Dec 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Authorized official

Name
Dr. Kevin Gary Galstyan, M.D.NPI 1396767471
Title
Owner/M.D.
Phone
(818) 502-4567

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
Obstetrics & Gynecology Physician 207V00000X A87868 CA Primary

Addresses

Primary practice location

222 W Eulalia St
211
Glendale, CA 91204-2849

Mailing address

222 W Eulalia St
211
Glendale, CA 91204-2849
Phone (818) 502-4567

Other identifiers 1

IdentifierTypeStateIssuer
A87868OtherCACA MEDICAL LICENSE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061209000045 CA Part B Supplier - Clinic/Group Practice 6800895442 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA; Reseda, CA

National Provider Directory

National Provider Directory

Locations

7601 Canby Ave
Ste 6B
Reseda, CA 91335
Phone (818) 674-4414

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324512000000",
    "number": "1649292715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "211",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "818-502-4567",
            "fax_number": "818-502-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W EULALIA ST",
            "address_2": "211",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042849",
            "telephone_number": "818-502-4567",
            "fax_number": "818-502-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN G. GALSTYAN M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2011-12-22",
        "status": "A",
        "authorized_official_last_name": "GALSTYAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "OWNER/M.D.",
        "authorized_official_telephone_number": "818-502-4567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A87868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE NUMBER",
            "identifier": "A87868",
            "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 Dec 22, 2011; 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.