Organization Active NPI

Armine Nazaryan, M.D., Medical Clinic,Inc., a Professional Corporation

  • General Practice Physician
  • Glendale, CA
National Provider Identifier
1689715070
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A85687 Issued in CA
Legal business name
ARMINE NAZARYAN, M.D., MEDICAL CLINIC,INC., A PROFESSIONAL CORPORATION
Practice address
221 S Glendale Ave
Glendale, CA 91205-1713
Phone
(818) 500-0716
Fax
(818) 500-0245
NPI assigned
Feb 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Authorized official

Name
Dr. Armine Nazaryan, M.D.NPI 1972505444
Title
Ceo, Cfo
Phone
(818) 500-0716

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
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A85687 CA Primary

Addresses

Primary practice location

221 S Glendale Ave
Glendale, CA 91205-1713

Mailing address

221 S Glendale Ave
Glendale, CA 91205-1713
Phone (818) 500-0716

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090804000342 CA Part B Supplier - Clinic/Group Practice 6002969375 Receives reassigned benefits from 1 practitioner
Practice locations: Glendale, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1048210Armine Nazaryan, MD Medical Clinic Inc221 S Glendale Ave, Glendale, CA 91205Certificate of waiverNov 22, 2027

National Provider Directory

National Provider Directory

Locations

221 S Glendale Ave
Glendale, CA 91205
Phone (818) 500-0716

Practitioners & affiliated clinicians

Practitioners 4

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": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1689715070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051713",
            "telephone_number": "818-500-0716",
            "fax_number": "818-500-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 S GLENDALE AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051713",
            "telephone_number": "818-500-0716",
            "fax_number": "818-500-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARMINE NAZARYAN, M.D., MEDICAL CLINIC,INC., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "NAZARYAN",
        "authorized_official_first_name": "ARMINE",
        "authorized_official_title_or_position": "CEO, CFO",
        "authorized_official_telephone_number": "818-500-0716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A85687",
            "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 Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.