Individual provider Active NPI

Adriana Dermgrdichian, PHARM.D.

  • Pharmacist
  • Glendale, CA
National Provider Identifier
1679340517
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
89047 Issued in CA
Practice address
2195 Galleria Way
Glendale, CA 91210-2101
Phone
(818) 334-1401
NPI assigned
Dec 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 89047 CA Primary

Addresses

Primary practice location

2195 Galleria Way
Glendale, CA 91210-2101

Mailing address

1629 Irving Ave
Glendale, CA 91201-1225
Phone (818) 524-9347

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
89047CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1679340517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 IRVING AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912011225",
            "telephone_number": "818-524-9347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 GALLERIA WAY",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912102101",
            "telephone_number": "818-334-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMGRDICHIAN",
        "first_name": "ADRIANA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "89047",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 11, 2023; 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.