GEORGE MUTAFYAN MD INC (NPI# 1316182447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316182447 |
| Entity Type | Organization |
| Organization Name | GEORGE MUTAFYAN MD INC |
| Practice Address |
1510 S Central Ave Suite 630 Glendale CA 91204-2500 |
| Practice Telephone | 8182407001 |
| Mailing Telephone | 8182407001 |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |
| Authorized Official Name | GEVORG MUTAFYAN (OWNER) |
| Authorized Official Telephone | 8182407001 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| Street Address |
1510 S CENTRAL AVE SUITE 630 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91204-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124020136 | Richard W Suda | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1510 S Central Ave, Suite 530, Glendale, CA 91204-2500 | 2005-08-10 |
| 1912381294 | Kyrillos Medical Group,inc | Specialist | 1510 S Central Ave, Suite 250, Glendale, CA 91204-2500 | 2015-07-16 |
| 1942699236 | Major Medical Management, Inc. | Clinic/Center | 1510 S Central Ave, Ste 120, Glendale, CA 91204-2500 | 2015-01-09 |
| 1124449384 | Mardi H. Mihranian | Specialist | 1510 S Central Ave, Suite 100, Glendale, CA 91204-2500 | 2013-12-13 |
| 1922429182 | Susan L. Chobanian, M.d. | Specialist | 1510 S Central Ave, Suite 100, Glendale, CA 91204-2500 | 2013-12-13 |
| 1861834178 | Ivan Brando Teves Aguilera | Podiatrist | 1510 S Central Ave, Ste 120, Glendale, CA 91204-2576 | 2013-07-28 |
| 1205176690 | Global Research Management, Inc | Specialist | 1510 S Central Ave, Suite 300, Glendale, CA 91204-2500 | 2013-02-21 |
| 1013206945 | Yen Tun Wang | Dermatology | 1510 S Central Ave, Suite 470, Glendale, CA 91204-2500 | 2011-03-31 |
| 1902105059 | Amandeep Kaur Randhawa | Podiatrist | 1510 S Central Ave, Suite 120, Glendale, CA 91204-2500 | 2011-03-15 |
| 1952543886 | Nathan Malcolm Miller | Chiropractor | 1510 S Central Ave, Suite 120, Glendale, CA 91204-2500 | 2009-03-24 |
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| 1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
| 1285163568 | Ez Trans, Inc. | Transportation Broker | 1626 S. Central Ave., Glendale, CA 91204 | 2017-06-08 |
| 1194254474 | Jenny Chung | Pharmacist | 3943 San Fernando Road, Glendale, CA 91204 | 2017-06-08 |
| 1396111886 | Fresenius Medical Care Glendale, LLC | Clinic/Center | 623 S Central Ave, Glendale, CA 91204 | 2015-08-19 |
| 1710302450 | New Age Foot and Ankle Podiatry PC | Podiatrist | 705 Ivy Street, Glendale, CA 91204 | 2014-03-04 |
| 1124454376 | Alber K. Karamanoukian Medical Clinic, Inc. | Clinic/Center | 810 S. Central Avenue, Suite 100, Glendale, CA 91204 | 2013-09-19 |
| 1548521156 | Glendale Plastic and Reconstructive Surgery Inc. | Plastic Surgery | 1500 S. Central Ave. #126, Glendale, CA 91204 | 2012-05-31 |
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| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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| 1154562379 | Serenity Sleep Laboratories Inc | Clinic/Center | 1141 N Brand Blvd Ste 201, Suite 201, Glendale, CA 91202-3647 | 2009-03-18 |
| 1245442433 | Gastroenterology Associates of Southern California | Clinic/Center | 222w. Eulalia St., Suite 301, Glendale, CA 91204 | 2007-05-03 |
| 1073666269 | Dimitrios P Bousounis Md | Clinic/Center | 200 W Silver Spring Dr Ste 255, Glendale, WI 53217-5058 | 2007-01-19 |
| 1588270730 | Pediatric Sedation of Arizona | Clinic/Center | 20100 N 51st Ave Ste B220, Glendale, AZ 85308-5145 | 2020-09-22 |
| 1184237877 | Sudeep Punia Md PC | Clinic/Center | 7330 N 99th Ave Ste 205, Glendale, AZ 85307-3018 | 2020-08-24 |
| 1699289660 | Alexander G Gevorgyan Md Inc | Clinic/Center | 1332 S Glendale Ave, Glendale, CA 91205-3349 | 2017-11-28 |
| 1396266870 | Teni Minaeian Chiropractic Inc | Clinic/Center | 1451 E Chevy Chase Dr Ste 201, Glendale, CA 91206-4056 | 2017-07-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.