Srinath Samudrala MD Inc

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

G83088 Issued in CA

Legal business name

SRINATH SAMUDRALA MD INC

Practice address

444 S San Vicente Blvd
Suite 800
Los Angeles, CA 90048-4165

Phone

(310) 423-8972

Fax

(310) 423-9470

NPI assigned

Feb 14, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Srinath Samudrala, MD

Title

Owner

Phone

(310) 423-8972

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• June Elaine Tiamzon Juanico, PA-C

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1477782720
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1033387899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 S SAN VICENTE BLVD",
            "address_2": "SUITE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484165",
            "telephone_number": "310-423-8972",
            "fax_number": "310-423-9470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 S SAN VICENTE BLVD",
            "address_2": "SUITE 800",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484165",
            "telephone_number": "310-423-8972",
            "fax_number": "310-423-9470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRINATH SAMUDRALA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "SAMUDRALA",
        "authorized_official_first_name": "SRINATH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-423-8972",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "G83088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G830880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shreya Sridhara, MD
• Mathangi Sridharan
• Michael Srienc
• Priya Srihari, MD
• Niwet Sriin
• Shreyas Srinivas
• Ravi N Srinivasa, MD
• Varsha Kiran Srinivasa
• Gokul Srinivasan
• Achyuth Sriram, MD

• Neurological Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.