Active NPI
Ronen Sarafian
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
National Provider Identifier
1699815696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 101360
- Practice address
- 467 N Lake Avene
Pasadena, CA 91101-1215 - Phone
- (626) 405-0440
- Fax
- (626) 405-0450
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 101360 | CA | Primary |
Addresses
Primary practice location
467 N Lake Avene
Pasadena, CA 91101-1215
Mailing address
467 N Lake Ave
Pasadena, CA 91101-1215
Phone (626) 405-0440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101360 | CA | MD | Durable Medical Equipment & Medical Supplies |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Avenue Medical Supply Inc. | Durable Medical Equipment & Medical Supplies | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Durable Medical Equipment & Medical Supplies
- Pasadena, CA
- NPI 1962703454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207526400000",
"number": "1699815696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "467 N LAKE AVE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011215",
"telephone_number": "626-405-0440",
"fax_number": "626-405-0450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "467 N LAKE AVENE",
"city": "PASADENA",
"state": "CA",
"postal_code": "911011215",
"telephone_number": "626-405-0440",
"fax_number": "626-405-0450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SARAFIAN",
"first_name": "RONEN",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-07",
"last_updated": "2008-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "CA",
"license": "101360",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.