Individual provider Active NPI

S Greg Panosian, OD

  • Optometrist
  • Glendale, CA
National Provider Identifier
1811972953
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
8301T Issued in CA
Practice address
607 N Central Ave
Glendale, CA 91203-1804
Phone
(818) 956-1010
Fax
(818) 543-6083
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 8301T CA Primary

Addresses

Primary practice location

607 N Central Ave
Glendale, CA 91203-1804

Mailing address

607 N Central Ave
Glendale, CA 91203-1804
Phone (818) 956-1010

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ75843ZMedicaidCA

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

State licenses

LicenseStateTypeSpecialty
8301TCAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811972953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031804",
            "telephone_number": "818-956-1010",
            "fax_number": "818-543-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 N CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031804",
            "telephone_number": "818-956-1010",
            "fax_number": "818-543-6083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANOSIAN",
        "first_name": "S",
        "middle_name": "GREG",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "8301T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ75843Z",
            "state": "CA"
        }
    ],
    "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 13, 2026; 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.