DERDERYAN MEDICAL GROUP INC. (NPI# 1457712309) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457712309 |
| Entity Type | Organization |
| Organization Name | DERDERYAN MEDICAL GROUP INC. |
| Practice Address |
4955 Van Nuys Blvd Ste 308 Sherman Oaks CA 91403-1811 |
| Practice Telephone | 6465521547 |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2016-03-18 |
| Authorized Official Name | DR. EDMOND VARUZHAN DERDERYAN (PRESIDENT/OWNER) |
| Authorized Official Telephone | 6465521547 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
4955 VAN NUYS BLVD STE 308 |
| City | SHERMAN OAKS |
| State | CA |
| Zip Code | 91403-1811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497807853 | Keino Andre Rutherford | Internal Medicine | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2007-01-17 |
| 1750930707 | Monica Abigail Arellano Keh | Nurse Practitioner | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2019-09-11 |
| 1265095921 | Hambartsoum Mekharian | Nurse Practitioner | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2019-04-18 |
| 1861993412 | Dmitriy Tretiak | Nurse Practitioner | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2018-02-27 |
| 1215443916 | Orion Healthcare Management Services | Case Management | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2017-12-18 |
| 1669817987 | Sridhar M Reddy | Internal Medicine | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2013-04-30 |
| 1114258944 | Edmond Derderian | Internal Medicine | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2010-01-18 |
| 1972836252 | Epic Cardiology | Internal Medicine | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2009-09-17 |
| 1679733646 | Georges Tanbe | Internal Medicine | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2008-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1245844596 | Montage Recovery California | Psychiatric Residential Treatment Facility | 15367 Valley Vista Blvd, Sherman Oaks, CA 91403 | 2020-09-03 |
| 1053870741 | Quality Life Experience | Assistant Behavior Analyst | 4723 1/4 Vista Del Monte, Sherman Oaks, CA 91403 | 2019-03-13 |
| 1871092254 | Andrew Pascual | Hospitalist | 4929 Van Nuys Blvs, Sherman Oaks, CA 91403 | 2018-02-12 |
| 1063941466 | Nancy Green Satenberg | Counselor | 4419 Van Nuys Blvd Ste. 301, Sherman Oaks, CA 91403 | 2017-06-08 |
| 1710414875 | Jeffery Edward Havig | Registered Nurse | 1536 Mission St, San Francisco, CA 91403 | 2017-05-18 |
| 1700310885 | Judy Koutal | Behavioral Analyst | 15720 Sutton St, Apt 201, Sherman Oaks, CA 91403 | 2017-04-17 |
| 1043742133 | Christa Maria Eskelin | Marriage & Family Therapist | 4419 Van Nuys Blvd, Suite 400, Sherman Oaks, CA 91403 | 2017-03-29 |
| 1760841431 | Dent All By Dr. Z | Dentist | 15301 Ventura Blvd. Ste U-5, Sherman Oaks, CA 91403 | 2016-02-23 |
| 1821456286 | Liana Kogan | Speech-Language Pathologist | 14569 Benefit Street, #312, Sherman Oaks, CA 91403 | 2016-02-01 |
| Find all providers in zip 91403 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437500014 | Stephen Engle | Internal Medicine | 14812 Dickens St Apt 301, Sherman Oaks, CA 91403-5206 | 2016-06-25 |
| 1700128451 | Marina Levin | Internal Medicine | 3724 Cody Rd, Sherman Oaks, CA 91403-5017 | 2013-03-20 |
| 1710231279 | Cyrus R Lavian, M.d., Inc | Internal Medicine | 16020 Valley Wood Rd, Suite 110, Sherman Oaks, CA 91403-4737 | 2012-11-06 |
| 1902188022 | San Fernando Valley Medical Group Inc | Internal Medicine | 4955 Van Nuys Blvd. #502, Sherman Oaks, CA 91403-1801 | 2011-09-14 |
| 1972743904 | Edward Morris Marshall | Internal Medicine | 3763 Regal Vista Dr, Sherman Oaks, CA 91403-4802 | 2009-03-04 |
| 1568636009 | J O Medical Professional Corporation | Internal Medicine | 13739 Riveside Drive, Unit B, Sherman Oaks, CA 91423-2417 | 2008-04-16 |
| 1902092042 | Saeed Eskandari | Internal Medicine | 4510 Murietta Ave, Ph-3, Sherman Oaks, CA 91423-2907 | 2007-09-21 |
| 1881809218 | Stacy Lorae Womack Batzdorf | Internal Medicine | 3849 Ventura Canyon, Sherman Oaks, CA 91423 | 2007-05-11 |
| 1336264993 | Jeffrey Allen Hay | Internal Medicine | 15512 Morrison St, Sherman Oaks, CA 91403-1047 | 2007-03-20 |
| 1497807853 | Keino Andre Rutherford | Internal Medicine | 4955 Van Nuys Blvd Ste 308, Sherman Oaks, CA 91403-1811 | 2007-01-17 |
| Find all providers in SHERMAN OAKS | ||||
| City | SHERMAN OAKS |
| Zip Code | 91403 |
Please comment or provide details below to improve the information on DERDERYAN MEDICAL GROUP INC..
| 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.