Individual provider Active NPI

Sophie M. Andriaschuk, M.D.

  • Anesthesiology Physician
  • Santa Monica, CA
National Provider Identifier
1063421378
Registry record updated Feb 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A31973 Issued in CA
Practice address
1328 22ND St
Santa Monica, CA 90404-2032
Phone
(310) 829-8202
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A31973 CA Primary

Addresses

Primary practice location

1328 22ND St
Santa Monica, CA 90404-2032

Mailing address

11999 San Vicente Blvd
Ste. 440
Los Angeles, CA 90049-5131
Phone (310) 440-3131

Other identifiers 1

IdentifierTypeStateIssuer
00A319730MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A31973CAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1063421378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD",
            "address_2": "STE. 440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495131",
            "telephone_number": "310-440-3131",
            "fax_number": "310-472-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 22ND ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042032",
            "telephone_number": "310-829-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRIASCHUK",
        "first_name": "SOPHIE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A31973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A319730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.