Shahin Derboghossians MD Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A42661 Issued in CA

Legal business name

SHAHIN DERBOGHOSSIANS MD INC

Practice address

1030 S Glendale
301
Glendale, CA 91205

Phone

(818) 507-4340

Fax

(818) 507-4348

NPI assigned

Oct 18, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Shahin Derboghossians, MDNPI 1710915038

Title

MD

Phone

(818) 507-4340

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Shahin Derboghossians, MD

  • Urology Physician
  • Glendale, CA
  • NPI 1710915038
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1811207483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE",
            "address_2": "301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-507-4340",
            "fax_number": "818-507-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S GLENDALE",
            "address_2": "301",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91205",
            "telephone_number": "818-507-4340",
            "fax_number": "818-507-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAHIN DERBOGHOSSIANS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "DERBOGHOSSIANS",
        "authorized_official_first_name": "SHAHIN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "818-507-4340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A42661",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A42661",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A426610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pushpa Hiro Shahani, M.D.
• Teodick Shahbandari, DO
• Hovhannes Shahbazyan
• Shahen Health Services Inc
• Shahen Healthcare Services Inc
• Anna Lala Shahinian
• Elizabeth Shahinian, PHARM.D
• Diana Shahinyan, NP
• Karen Shahmoradi
• Christ Shahnazari

• Urology Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.