Individual provider Active NPI

Edgar Ghukasyan

  • Non-emergency Medical Transport (VAN)
  • Glendale, CA
National Provider Identifier
1710797790
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Practice address
1030 E Palmer Ave Apt 9
Glendale, CA 91205-3500
Phone
(747) 758-1247
NPI assigned
Jan 10, 2025
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X CA Primary

Addresses

Primary practice location

1030 E Palmer Ave Apt 9
Glendale, CA 91205-3500

Mailing address

1030 E Palmer Ave Apt 9
Glendale, CA 91205-3500
Phone (747) 758-1247

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

NPI Registry JSON

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

{
    "created_epoch": "1736467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1710797790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E PALMER AVE APT 9",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053500",
            "telephone_number": "747-758-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E PALMER AVE APT 9",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912053500",
            "telephone_number": "747-758-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHUKASYAN",
        "first_name": "EDGAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-10",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "CA",
            "license": null,
            "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 Jan 10, 2025; 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.