Active NPI
Koruon Daldalyan, M.D.
- Internal Medicine Physician
- Sherman Oaks, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A158942
- Practice address
- 13320 Riverside Dr Ste 104
Sherman Oaks, CA 91423-2550 - Phone
- (818) 574-6189
- NPI assigned
- Apr 6, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 61669 | AZ | |
| Internal Medicine Physician | 207R00000X | A158942 | CA | Primary |
Addresses
Primary practice location
13320 Riverside Dr Ste 104
Sherman Oaks, CA 91423-2550
Mailing address
13320 Riverside Dr Ste 104
Sherman Oaks, CA 91423-2550
Phone (818) 574-6189
Other practice location 1
13416 N 32nd St Ste 109
Phoenix, AZ 85032-6000
Phone (818) 574-6189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- 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 |
|---|---|---|---|---|
| I20250902003071 | AZ | Order and Referring Only - Internal Medicine | 8729308671 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61669 | AZ | MD | Internal Medicine Physician |
| A158942 | CA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Joey Brett MD a Professional Medical Corporation | Current | Accepting new patients | |
| Loyal Hospice & Palliative Care, LLC | Current | Accepting new patients | |
| Loyal Hospice & Palliative Care, LLC | Current | Accepting new patients | |
| Noble Care Services West LLC | Past | Accepting new patients |
Locations
13320 Riverside Dr
Ste 104
Sherman Oaks, CA 91423
Phone (818) 574-6189
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Serenity Hospice | Hospice | Contracted Managing Employee | Mar 16, 2023 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Community Based Hospice Care Agency
- Fort Mohave, AZ
- NPI 1841882198
Contracted Managing Employee
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Sherman Oaks, CA
- NPI 1003927872
-
- Home Health Agency
- Fort Mohave, AZ
- NPI 1154002889
-
- Community Based Hospice Care Agency
- Fort Mohave, AZ
- NPI 1841882198
-
- Community Based Hospice Care Agency
- Glendale, AZ
- NPI 1700479136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755561600000",
"number": "1679937643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13320 RIVERSIDE DR STE 104",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914232550",
"telephone_number": "818-574-6189",
"fax_number": "818-574-6218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13320 RIVERSIDE DR STE 104",
"city": "SHERMAN OAKS",
"state": "CA",
"postal_code": "914232550",
"telephone_number": "818-574-6189"
}
],
"practiceLocations": [
{
"address_1": "13416 N 32nd St Ste 109",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850326000",
"country_code": "US",
"telephone_number": "818-574-6189",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DALDALYAN",
"first_name": "KORUON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-06",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "61669",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A158942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sherman Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.