Soma Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A44878 Issued in CA

Legal business name

SOMA MEDICAL GROUP

Practice address

1959 Kingsdale Ave
Redondo Beach, CA 90278-3417

Phone

(310) 214-1000

Fax

(310) 214-8540

NPI assigned

Jul 23, 2006

Last updated

Dec 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sohail Davoudian, M.D.NPI 1255462248

Title

Medical Director

Phone

(310) 214-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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 4

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.

• Sohail Davoudian, M.D.

  • Internal Medicine Physician
  • Redondo Beach, CA
  • NPI 1255462248
  Medicare reassignment NPD Authorized official
• Josephine Reyes Cabugnason

  • Family Nurse Practitioner
  • Redondo Beach, CA
  • NPI 1336585819
  Medicare reassignment NPD
• Annalissa Llavan Flores, NP

  • Nurse Practitioner
  • Redondo Beach, CA
  • NPI 1740626100
  Medicare reassignment NPD
• Roggielyz Yosores Padilla, NP-C

  • Nurse Practitioner
  • Torrance, CA
  • NPI 1124566724
  Medicare reassignment NPD

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1063434900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5090",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902789290",
            "telephone_number": "310-214-1000",
            "fax_number": "310-214-8540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 KINGSDALE AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783417",
            "telephone_number": "310-214-1000",
            "fax_number": "310-214-8540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "DAVOUDIAN",
        "authorized_official_first_name": "SOHAIL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-214-1000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A44878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0059090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connie L Snelson, L.AC.,,CA, NCCA,
• Socal Behavioral Medicine, Inc. (SoCal Behavioral Medicine)
• Monica Johana Solares
• Jessica Soliman
• Barry Solomon, B.S., M.A.
• Christine Soria, OTR/L
• Zachary Soufl, DC
• South Bay Birth (South Bay Birth Birthing Center)
• South Bay Birth
• South Bay Children's Health Center

• Internal Medicine Physician in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.