Organization Active NPI

Stephan Grigorian MD Inc

Doing business as Glenpath Diagnostics

  • Anatomic Pathology & Clinical Pathology Physician
  • Glendale, CA
National Provider Identifier
1689980914
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A88170 Issued in CA
Legal business name
STEPHAN GRIGORIAN MD INC
Doing business as
Glenpath Diagnostics
Practice address
800 S Central Ave
Suite 208
Glendale, CA 91204-4370
Phone
(818) 507-1200
Fax
(818) 507-1200
NPI assigned
Aug 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Authorized official

Name
Dr. Stephan Robert Grigorian, M.D.
Title
Owner / Physician
Phone
(818) 507-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X A88170 CA Primary

Addresses

Primary practice location

800 S Central Ave
Suite 208
Glendale, CA 91204-4370

Mailing address

800 S Central Ave
Suite 208
Glendale, CA 91204-4370
Phone (818) 507-1200

Other names 1

  • Glenpath Diagnostics Doing business as

National Provider Directory

National Provider Directory

Locations

800 S Central Ave
Ste 304
Glendale, CA 91204
Phone (818) 507-0006

800 S Central Ave
Ste 208
Glendale, CA 91204
Phone (818) 404-2615

NPI Registry JSON

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

{
    "created_epoch": "1282608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1689980914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-507-1200",
            "fax_number": "818-507-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE",
            "address_2": "SUITE 208",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-507-1200",
            "fax_number": "818-507-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHAN GRIGORIAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-24",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "GRIGORIAN",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "818-507-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A88170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glenpath Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 3, 2013; 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.