Individual provider Active NPI

Christopher Khachik Khoshoryan, MD

  • Psychiatry Physician
  • Burbank, CA
National Provider Identifier
1659995280
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A195863 Issued in CA
Practice address
191 S Buena Vista St Ste 300
Burbank, CA 91505-4556
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
May 29, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4351046856 MI
Psychiatry Physician 2084P0800X A195863 CA Primary

Addresses

Primary practice location

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556

Mailing address

191 S Buena Vista St Ste 300
Burbank, CA 91505-4556
Phone (925) 282-1778

Other practice location 1

461 W Huron St
Pontiac, MI 48341-1601
Phone (248) 857-7200

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
I20240715002506 CA Practitioner - Psychiatry 4385189398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pacific Coast Psychiatric Associates IncGroup PAC ID 2567469174, 637 clinicians

Practice addresses (Care Compare)

191 S Buena Vista St
Suite 300
Burbank, CA 91505-4556
Phone (925) 282-1778

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A195863CAMDPsychiatry Physician
4351046856MIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc Psychiatry CurrentSince Aug 1, 2024 Accepting new patients

Locations

191 S Buena Vista St
Ste 300
Burbank, CA 91505
Phone (818) 566-9707

6200 Wilshire Blvd
Ste 1410
Los Angeles, CA 90048
Phone (323) 403-0474

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.christopherkhoshoryan@148377.advancedmd-direct.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1659995280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 S BUENA VISTA ST STE 300",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054556",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "461 W Huron St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483411601",
            "country_code": "US",
            "telephone_number": "248-857-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHOSHORYAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "KHACHIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-29",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4351046856",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A195863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.