Individual provider Active NPI

Shant Ogtanyan

  • Pharmacist
  • Glendale, CA
National Provider Identifier
1871327692
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
89989 Issued in CA
Practice address
411 N Central Ave Ste 100
Glendale, CA 91203-1898
Phone
(818) 244-1195
NPI assigned
Aug 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 89989 CA Primary

Addresses

Primary practice location

411 N Central Ave Ste 100
Glendale, CA 91203-1898

Mailing address

17051 Horace St
Granada Hills, CA 91344-4922
Phone (818) 312-2161

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
89989CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aracola Inc CurrentSince Sep 1, 2024 Accepting new patients
Aracola, Inc PastSince Sep 1, 2024 Accepting new patients

Locations

411 N Central Ave
Ste 100
Glendale, CA 91203
Phone (818) 244-1195

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1871327692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17051 HORACE ST",
            "city": "GRANADA HILLS",
            "state": "CA",
            "postal_code": "913444922",
            "telephone_number": "818-312-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 N CENTRAL AVE STE 100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031898",
            "telephone_number": "818-244-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGTANYAN",
        "first_name": "SHANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "89989",
            "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 Aug 26, 2024; 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.