Derderyan Medical Group Inc.
NPI 1457712309ActiveOrganization· Internal Medicine· Sherman Oaks, CA
Internal Medicine in Sherman Oaks, California, registered in NPPES in March 2016. The authorized official on file is Edmond Varuzhan Derderyan, M.D, President/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1457712309 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 18, 2016 |
| Last updated in NPPES | Feb 7, 2021 |
| Certified by provider | Feb 7, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (CA) |
|---|
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