Individual provider Active NPI

Koruon Daldalyan, M.D.

  • Internal Medicine Physician
  • Sherman Oaks, CA
National Provider Identifier
1679937643
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A158942 Issued in CA
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

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250902003071 AZ Order and Referring Only - Internal MedicinePractitioner - Internal MedicinePractitioner - Hospice/Palliative Care 8729308671

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61669AZMDInternal Medicine Physician
A158942CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joey Brett MD a Professional Medical Corporation CurrentSince Nov 6, 2022 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 PastSince Jan 21, 2021 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.

FacilityTypeRoleSince
Serenity HospiceFort Mohave, AZ, CCN 031746 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.

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.

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

Verify at the official NPI Registry.