Organization Active NPI

Michael Aaron Lalezarian, MD Corp

  • Vascular & Interventional Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1891314290
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
MICHAEL AARON LALEZARIAN, MD CORP
Practice address
1082 Glendon Ave
Los Angeles, CA 90024-2908
Phone
(310) 906-2270
Fax
(310) 861-8824
NPI assigned
Apr 15, 2020
Last updated
Mar 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Dr. Michael Lalezarian, MDNPI 1023245230
Title
Owner/Physician
Phone
(310) 991-9994

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X NU Primary

Addresses

Primary practice location

1082 Glendon Ave
Los Angeles, CA 90024-2908

Mailing address

127 N Gardner St
Los Angeles, CA 90036-2719
Phone (310) 301-6800

Other practice location 1

1411 S Garfield Ave Ste 303
Alhambra, CA 91801-5043
Phone (310) 906-2270

Other practice location 2

1520 N Mountain Ave Unit E-205
Ontario, CA 91762-1128
Phone (310) 906-2270

Other practice location 3

930 W Main St
Barstow, CA 92311-2654
Phone (310) 906-2270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200601001535 CA Part B Supplier - Clinic/Group Practice 9830510791 Receives reassigned benefits from 2 practitioners
Practice locations: Apple Valley, CA; Covina, CA; Downey, CA; Montclair, CA; Sylmar, CA; Upland, CA

National Provider Directory

National Provider Directory

Locations

18064 Wika Rd
Ste 101
Apple Valley, CA 92307
Phone (760) 242-2338

1520 N Mountain Ave
Unit E205
Ontario, CA 91762
Phone (310) 906-2270

14445 Olive View Dr
Ste 2D115
Sylmar, CA 91342
Phone (760) 515-1000

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1891314290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N GARDNER ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900362719",
            "telephone_number": "310-301-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1082 GLENDON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900242908",
            "telephone_number": "310-906-2270",
            "fax_number": "310-861-8824"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 S Garfield Ave Ste 303",
            "address_purpose": "LOCATION",
            "city": "Alhambra",
            "state": "CA",
            "postal_code": "918015043",
            "country_code": "US",
            "telephone_number": "310-906-2270",
            "fax_number": "310-861-8824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1520 N Mountain Ave Unit E-205",
            "address_purpose": "LOCATION",
            "city": "Ontario",
            "state": "CA",
            "postal_code": "917621128",
            "country_code": "US",
            "telephone_number": "310-906-2270",
            "fax_number": "310-861-8824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 W Main St",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923112654",
            "country_code": "US",
            "telephone_number": "310-906-2270",
            "fax_number": "310-861-8824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHAEL AARON LALEZARIAN, MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-15",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "LALEZARIAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "310-991-9994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.