Nilanthi Soori, MD
Individual provider Active NPI Family Medicine Physician · Tohatchi, NM
NPI 1003881665 · NPPES record last updated Nov 28, 2012
Key facts
- NPI
- 1003881665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- A93967 (CA)
- Practice address
- 007 Choosgai Drive
Tohatchi, NM 87325 - Phone
- (505) 733-8400
- Fax
- (505) 722-1310
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00044845 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the University of California | Past | Accepting new patients | |
| Spirit Lake Tribe | Past | Accepting new patients | |
| DHHS, PHS, Naihs, Gallup Indian Medical Center | Past | Accepting new patients | |
| Spirit Lake Health Center | Past | Accepting new patients | |
| Pine Ridge Indian Health Service Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD00044845 | WA | |
| Family Medicine Physician | 207Q00000X | A93967 | CA | Yes |
Addresses
Primary practice location
007 Choosgai Drive
Tohatchi, NM 87325
Mailing address
305 East Center Ave.
Visalia, CA 93291-6331
Phone (559) 737-4700
Other providers in Tohatchi, NM
- Jwan M Mustafa
- Sophia Claire Ries
- William I Schuman
- Pamela Smiley
- Velma M. Smith
- Gwendolyn Spencer
- Tohatchi Health Center Pharmacy
- Lenora J Woody
All providers in Tohatchi, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.