Active NPI
Vladimir Grigoryants, MD
- Plastic Surgery Physician
- Glendale, CA
National Provider Identifier
1790849503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- A93719
- Practice address
- 1808 Verdugo Blvd
Suite 208
Glendale, CA 91208-1477 - Phone
- (818) 952-7070
- Fax
- (818) 952-7993
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | A93719 | CA | Primary |
Addresses
Primary practice location
1808 Verdugo Blvd
Suite 208
Glendale, CA 91208-1477
Mailing address
412 N Isabel St Apt D
Glendale, CA 91206-3333
Phone (800) 540-0508
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A93719 | CA | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1790849503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 N ISABEL ST APT D",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912063333",
"telephone_number": "800-540-0508",
"fax_number": "818-952-7993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1808 VERDUGO BLVD",
"address_2": "SUITE 208",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912081477",
"telephone_number": "818-952-7070",
"fax_number": "818-952-7993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGORYANTS",
"first_name": "VLADIMIR",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CA",
"license": "A93719",
"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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.