Active NPI
Lydia Baghdaseriani
- Chiropractor
- Burbank, CA
National Provider Identifier
1992726012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC24776
- Practice address
- 310 E Providencia Ave Apt 106
Burbank, CA 91502-2756 - Phone
- (818) 662-0208
- Fax
- (661) 822-2049
- NPI assigned
- Jul 22, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC24776 | CA | Primary |
Addresses
Primary practice location
310 E Providencia Ave Apt 106
Burbank, CA 91502-2756
Mailing address
310 E Providencia Ave Apt 106
Burbank, CA 91502-2756
Phone (818) 662-0208
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DC0247760 | Other | CA | BLUE SHIELD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DC24776 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1992726012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 E PROVIDENCIA AVE APT 106",
"city": "BURBANK",
"state": "CA",
"postal_code": "915022756",
"telephone_number": "818-662-0208",
"fax_number": "661-822-2049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "310 E PROVIDENCIA AVE APT 106",
"city": "BURBANK",
"state": "CA",
"postal_code": "915022756",
"telephone_number": "818-662-0208",
"fax_number": "661-822-2049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAGHDASERIANI",
"first_name": "LYDIA",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-22",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC24776",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "DC0247760",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burbank, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.