MEDWISE MEDICAL CLINIC, INC (NPI# 1609813096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609813096 |
| Entity Type | Organization |
| Organization Name | MEDWISE MEDICAL CLINIC, INC |
| Other Organization Name | MEDWISE MEDICAL CLINIC |
| Practice Address |
540 N Central Ave Suite 203 Glendale CA 91203-1916 |
| Mailing Address |
Po Box 601 Glendale CA 91209-0601 |
| Practice Telephone | 8182420500 |
| Mailing Telephone | 8182420500 |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. SHALIMAN EIVAZZADEH (OWNER) |
| Authorized Official Telephone | 8182420500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | A42072 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A420721 | 05 |
| Other Name | Type Code |
|---|---|
| MEDWISE MEDICAL CLINIC | Former Legal Business Name - Organization |
| Street Address |
540 N CENTRAL AVE SUITE 203 |
| City | GLENDALE |
| State | CA |
| Zip Code | 91203-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265784532 | Lazik Der Sarkissian, Md A Professional Corporation | Anesthesiology | 540 N Central Ave, 205, Glendale, CA 91203-1916 | 2012-10-10 |
| 1376858852 | H F Eshraghi Md A Professional Corporation | Internal Medicine | 540 N Central Ave, Ste 110, Glendale, CA 91203-1916 | 2010-08-09 |
| 1447585070 | Medx Diagnostics Inc | Psychiatry & Neurology | 540 N Central Ave, Suite 302, Glendale, CA 91203-1916 | 2009-10-15 |
| 1336330471 | Irina Chilian Md Inc | Psychiatry & Neurology | 540 N Central Ave, Suite# 302, Glendale, CA 91203-1916 | 2007-08-05 |
| 1134325707 | Carineh Nazarian D.d.s Inc. | Dentist | 540 N Central Ave, Suite 108, Glendale, CA 91203-1916 | 2007-06-21 |
| 1083839997 | Rubic Simanian | Dentist | 540 N Central Ave, Suite 209, Glendale, CA 91203 | 2007-04-16 |
| 1780807040 | Androohi Bahariance | Acupuncturist | 540 N Central Ave, Suite 202, Glendale, CA 91203-1916 | 2007-04-11 |
| 1962522177 | Susanna Yerzinkian Md | Pediatrics | 540 N Central Ave, Suite 301, Glendale, CA 91203-1916 | 2007-03-30 |
| 1801951975 | Nazik Coromoto Utuchian | Dietitian, Registered | 540 N Central Ave, Suite # 303, Glendale, CA 91203-1916 | 2006-12-27 |
| 1275695785 | Howard J. Quan | Dentist | 540 N Central Ave, Ste 204, Glendale, CA 91203-1916 | 2006-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487115044 | Family & Friends Home Health Care Inc | Home Health | 417 W Arden St Suite 106a, Glendale, CA 91203 | 2019-03-27 |
| 1801354758 | Remedy Medical of California PC | Emergency Medicine | 138 N. Brand Blvd., Ste. 200, Unit 163, Glendale, CA 91203 | 2019-03-11 |
| 1609381730 | Envoy Hospice Care Inc | Hospice Care, Community Based | 5002 N Central Ave Ste 510, Glendale, CA 91203 | 2017-12-12 |
| 1093227712 | Goarik Susan Akopyan | Case Manager/Care Coordinator | 237 N Central Ave, Glendale, Ca 91203, Glendale, CA 91203 | 2017-11-03 |
| 1588190664 | Vanessa Guzman | Physician Assistant | 600 N. Central Ave, 322, Glendale, CA 91203 | 2017-05-10 |
| 1114465796 | Elizabeth Pedroza Estrada | Case Manager/Care Coordinator | 237 North Glendale, Glendale, CA 91203 | 2017-02-03 |
| 1477090934 | Blue Med-ride Medical Transportation | Non-emergency Medical Transport (VAN) | 121 W Lexington Dr # L200, Glendale, CA 91203 | 2017-01-23 |
| 1427593557 | Ofelia Oundjian | Counselor | 237 N Central Ave., Glendale, CA 91203 | 2016-12-28 |
| 1316396823 | Shaunak Jaiprakash Intwala | Pharmacist | 330 N Brand Blvd Ste 155, Glendale, CA 91203 | 2016-06-06 |
| 1295117315 | Luis Ernesto Garcia Artiga | Licensed Vocational Nurse | 500 N Central Ave Suite 250, Glendale, CA 91203 | 2015-06-25 |
| Find all providers in zip 91203 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1902164320 | Lotus Medical Group | General Practice | 541 W Colorado St Ste 205, Glendale, CA 91204-3640 | 2012-04-24 |
| 1023390770 | Armen Nercessian Do Inc | General Practice | 1122 N Brand Blvd Ste 101, Glendale, CA 91202-2571 | 2011-09-19 |
| 1609165992 | Leslie Moss Kalman | General Practice | 1015 Hillcroft Rd, Glendale, CA 91207-1541 | 2011-04-07 |
| 1184934648 | Luis A Perez Md Inc | General Practice | 1220 S Central Ave Ste 102, Glendale, CA 91204-3805 | 2010-10-18 |
| 1457676793 | Elizabeth Remedios Md Inc | General Practice | 423 W Colorado St, Glendale, CA 91204-1537 | 2010-03-30 |
| 1174855480 | Abdelgabar Mohamed Mohamdian | General Practice | 8528 N 43rd Dr, Glendale, AZ 85302-5302 | 2010-02-11 |
| 1578892808 | Alber Karamanoukian | General Practice | 800 S Central Ave., Glendale, CA 91204-2902 | 2009-12-16 |
| 1376871566 | Agababian Medical Clinic, Inc | General Practice | 800 S Central Ave Ste 301, Glendale, CA 91204-4388 | 2009-11-26 |
| 1174857791 | Triad Clinic Pllc | General Practice | 4902 W Ironwood Dr, Glendale, AZ 85302-2402 | 2009-09-29 |
| Find all providers in GLENDALE | ||||
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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.