Organization Active NPI

Glendale Diagnostic Imaging Network Medical Office, Inc

  • Diagnostic Radiology Physician
  • Glendale, CA
National Provider Identifier
1902814759
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G84687 Issued in CA
Legal business name
GLENDALE DIAGNOSTIC IMAGING NETWORK MEDICAL OFFICE, INC
Practice address
800 S Central Ave Ste 100B
Glendale, CA 91204-4375
Phone
(818) 548-8333
Fax
(818) 548-7888
NPI assigned
Aug 4, 2006
Last updated
Aug 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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

Authorized official

Name
Kristine Ter-Minasyan
Title
Administrator
Phone
(818) 986-8215

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G84687 CA Primary

Addresses

Primary practice location

800 S Central Ave Ste 100B
Glendale, CA 91204-4375

Mailing address

4910 Van Nuys Blvd Ste 108
Sherman Oaks, CA 91403-1757
Phone (818) 548-8333

Other practice location 1

403 S. Glendale Ave
Glendale, CA 91205
Phone (818) 546-1929

Other practice location 2

13311 Victory Blvd
Van Nuys, CA 91401-1832
Phone (747) 777-8494

Other practice location 3

4910 Van Nuys Blvd Ste 108
Sherman Oaks, CA 91403-1757
Phone (818) 986-8215

Other practice location 4

8641 Wilshire Blvd Ste 105
Beverly Hills, CA 90211-2919
Phone (310) 919-3330

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050920000539 CA Part B Supplier - Clinic/Group Practice 6305877051 Receives reassigned benefits from 4 practitioners
Practice locations: Beverly Hills, CA; Glendale, CA; Sherman Oaks, CA

National Provider Directory

National Provider Directory

Locations

1220 S Central Ave
Ste 104
Glendale, CA 91204
Phone (818) 240-7511

403 S Central Ave
Glendale, CA 91204

800 S Central Ave
Ste 100B
Glendale, CA 91204
Phone (818) 548-8333

4910 Van Nuys Blvd
Ste 108
Sherman Oaks, CA 91403
Phone (818) 548-8333

Practitioners & affiliated clinicians

Practitioners 5

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": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787788800000",
    "number": "1902814759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 VAN NUYS BLVD STE 108",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031757",
            "telephone_number": "818-548-8333",
            "fax_number": "818-548-7888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 100B",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044375",
            "telephone_number": "818-548-8333",
            "fax_number": "818-548-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 S. Glendale Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "91205",
            "country_code": "US",
            "telephone_number": "818-546-1929",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13311 Victory Blvd",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914011832",
            "country_code": "US",
            "telephone_number": "747-777-8494",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4910 Van Nuys Blvd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Sherman Oaks",
            "state": "CA",
            "postal_code": "914031757",
            "country_code": "US",
            "telephone_number": "818-986-8215",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8641 Wilshire Blvd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902112919",
            "country_code": "US",
            "telephone_number": "310-919-3330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GLENDALE DIAGNOSTIC IMAGING NETWORK MEDICAL OFFICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A",
        "authorized_official_last_name": "TER-MINASYAN",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-986-8215"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G84687",
            "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 27, 2026; 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.