Individual provider Active NPI

Anatoly Aivazian, D.C.

  • Chiropractor
  • Northridge, CA
National Provider Identifier
1861619124
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC20492 Issued in CA
Practice address
8925 Reseda Blvd
Northridge, CA 91324-4040
Phone
(818) 886-4976
Fax
(818) 886-5820
NPI assigned
Apr 19, 2007
Last updated
Nov 30, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC20492 CA Primary

Addresses

Primary practice location

8925 Reseda Blvd
Northridge, CA 91324-4040

Mailing address

8925 Reseda Blvd
Northridge, CA 91324-3915
Phone (818) 886-4976

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

State licenses

LicenseStateTypeSpecialty
DC20492CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1861619124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8925 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913243915",
            "telephone_number": "818-886-4976",
            "fax_number": "818-886-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8925 RESEDA BLVD",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913244040",
            "telephone_number": "818-886-4976",
            "fax_number": "818-886-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIVAZIAN",
        "first_name": "ANATOLY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC20492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.