Eagle Rock Medical Center

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EAGLE ROCK MEDICAL CENTER

Practice address

4867 Eagle Rock Blvd Ste 1
Los Angeles, CA 90041-2649

Phone

(323) 254-6754

Fax

(323) 257-5949

NPI assigned

Jul 18, 2023

Organization subpart

No

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

Authorized official

Name

Ayuna Panossian, MDNPI 1952423014

Title

Owner

Phone

(323) 254-6754

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ayuna K Panossian, MD

  • Family Medicine Physician
  • Burbank, CA
  • NPI 1952423014
  Medicare reassignment Care Compare group NPD Authorized official
• Mercy Ragas Florida, NP

  • Family Nurse Practitioner
  • La Crescenta, CA
  • NPI 1134749286

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jude T Gineta, NP

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1093401457
  Medicare reassignment Care Compare group NPD
• Lena Al-Sarraf

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1538317730
  NPD (past)
• Edgar Corrales Banez, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1275644098
  NPD (past)
• Maria Estela B Castro, NP-C

  • Family Nurse Practitioner
  • Glendale, CA
  • NPI 1720470842
  NPD (past)

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

{
    "created_epoch": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1972283760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4867 EAGLE ROCK BLVD STE 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412649",
            "telephone_number": "323-254-6754",
            "fax_number": "323-257-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4867 EAGLE ROCK BLVD STE 1",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900412649",
            "telephone_number": "323-254-6754",
            "fax_number": "323-257-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE ROCK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "PANOSSIAN",
        "authorized_official_first_name": "AYUNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-254-6754",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Yvonne Eagilen, D.D.S.
• Eagle Classic Wellness Inc
• Eagle Home Care LLC
• Eagle Medical Transportation
• Eagle Rock Adult Day Health Care Center LLC
• Eagle Rock Medlink Group Inc
• Eagle-1 Healthcare Inc
• Alison Eagle, M.A. AMFT
• Luke Smile Eagle, CLS
• Jennifer Lynn Eakes, NBHWC, RYT

• Family Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, 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 Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.