Ridgecrest Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

RIDGECREST MEDICAL GROUP INC

Practice address

12233 La Maida St
Valley Village, CA 91607-3622

Phone

(323) 229-4217

NPI assigned

Sep 8, 2025

Last updated

Oct 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Syuzanna Markosyan, NPNPI 1245075126

Title

President & Ceo

Phone

(323) 229-4217

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Syuzanna Markosyan, FNP

  • Family Nurse Practitioner
  • Sunland, CA
  • NPI 1245075126
  Medicare reassignment NPD Authorized official
• Sieghart H Ponhold, M.D

  • Family Medicine Physician
  • Norwalk, CA
  • NPI 1891883955
  Medicare reassignment NPD

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1942181938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25044 PEACHLAND AVE STE 209",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913215751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12233 LA MAIDA ST",
            "city": "VALLEY VILLAGE",
            "state": "CA",
            "postal_code": "916073622",
            "telephone_number": "323-229-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGECREST MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "MARKOSYAN",
        "authorized_official_first_name": "SYUZANNA",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "323-229-4217",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Valley Village, CA
• Providers in Valley Village, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.