California Sports and Spine Institute, PC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

A118692 Issued in CA

Legal business name

CALIFORNIA SPORTS AND SPINE INSTITUTE, PC

Practice address

317 S Brand Blvd Ste a-104
Glendale, CA 91204-1701

Phone

(818) 338-6860

Fax

(888) 425-9079

NPI assigned

Mar 23, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Maxim Moradian, MDNPI 1497924864

Title

President/Owner

Phone

(818) 913-9356

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• California Sports and Spine Institute, PC

  • Physical Medicine & Rehabilitation Physician
  • Arcadia, CA
  • NPI 1972194546
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maxim Moradian, M.D.

  • Interventional Pain Medicine Physician
  • Glendale, CA
  • NPI 1497924864

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD Authorized official
• Jungwoo James Lieu, DO

  • Physical Medicine & Rehabilitation Physician
  • Montclair, CA
  • NPI 1699330506
  Medicare reassignment Care Compare group NPD
• Revik Vartanian, DO

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Arcadia, CA
  • NPI 1811352040

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771545600000",
    "number": "1801327606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8323",
            "city": "LA CRESCENTA",
            "state": "CA",
            "postal_code": "912240323",
            "telephone_number": "818-913-9356",
            "fax_number": "888-425-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 S BRAND BLVD STE A-104",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041701",
            "telephone_number": "818-338-6860",
            "fax_number": "888-425-9079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA SPORTS AND SPINE INSTITUTE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-23",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A",
        "authorized_official_last_name": "MORADIAN",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "818-913-9356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A118692",
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A118692",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "A118692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• California Primary Health Care Corp
• California Quality Care Home Health Agency, Inc.
• California Radiology Management Inc
• California Specialty Medical Group
• California Spinecare Institute Inc
• California Surgical Multi-Specialty Group Inc.
• California Therapy Center & Psychological Services Inc
• California Vascular Health Institute LLC
• Californiacarecorp
• Martn Kyle Poblete Calingo

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.