Organization Active NPI

Galina Vardanyan, O.D., Optometry Corporation

  • Optometrist
  • Burbank, CA
National Provider Identifier
1689427411
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GALINA VARDANYAN, O.D., OPTOMETRY CORPORATION
Practice address
2005 W Alameda Ave
Burbank, CA 91506-2932
Phone
(818) 476-4639
NPI assigned
Apr 10, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Galina Gabby Vardanyan, ODNPI 1467929265
Title
Ceo
Phone
(818) 476-4639

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

2005 W Alameda Ave
Burbank, CA 91506-2932

Mailing address

2005 W Alameda Ave
Burbank, CA 91506-2932
Phone (818) 476-4639

Other names 1

  • Eyes on Burbank Optometry Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240619001335 CA Part B Supplier - Clinic/Group Practice 2365985306 Receives reassigned benefits from 1 practitioner
Practice locations: Burbank, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1689427411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 W ALAMEDA AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062932",
            "telephone_number": "818-476-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W ALAMEDA AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062932",
            "telephone_number": "818-476-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALINA VARDANYAN, O.D., OPTOMETRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-04-10",
        "status": "A",
        "authorized_official_last_name": "VARDANYAN",
        "authorized_official_first_name": "GALINA",
        "authorized_official_middle_name": "GABBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-476-4639",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyes on Burbank Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; 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.