Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lucy Vardapetyan

Individual provider Physician Assistant · NPI 1164018966

Lucy Vardapetyan is a Physician Assistant in North Hollywood, California. Qualified in 2020, 6 years ago. Practices with Shine Mmg Inc, a 25-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
6
Licensed in
CA
In the registry since
2020

Practice location Address checks out

7763 Rhodes Ave
North Hollywood, CA 91605-2350
Phone: (818) 939-8545
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (CA)

Record details

NPI number1164018966
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 15, 2020
Last updated in NPPESDecember 15, 2020
Certification dateDecember 15, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Shine Mmg Inc — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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