Healthcare Provider Details

I. General information

NPI: 1265176879
Provider Name (Legal Business Name): DION BANOIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 W RIVERSIDE DR STE 120
BURBANK CA
91505-4339
US

IV. Provider business mailing address

1635 RAMONA AVE
GLENDALE CA
91208-2018
US

V. Phone/Fax

Practice location:
  • Phone: 818-246-8000
  • Fax:
Mailing address:
  • Phone: 818-926-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA204396
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberCS40420
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: