Individual provider Active NPI

Carole Ann Sofio, MD

  • Internal Medicine Physician
  • Orange, CA
National Provider Identifier
1063501468
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G56506 Issued in CA
Practice address
1310 W. Stewart Dr.
Suite 602
Orange, CA 92868-3857
Phone
(714) 639-0414
Fax
(714) 639-3313
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G56506 CA Primary

Addresses

Primary practice location

1310 W. Stewart Dr.
Suite 602
Orange, CA 92868-3857

Mailing address

1310 W. Stewart Dr.
Suite 602
Orange, CA 92868-3857
Phone (714) 639-0414

Other names 1

  • Mrs. Carole Sofio Malchow Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051017001052 CA Practitioner - Internal Medicine 1052337235 Practice locations: Orange, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G56506CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1063501468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W. STEWART DR.",
            "address_2": "SUITE 602",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683857",
            "telephone_number": "714-639-0414",
            "fax_number": "714-639-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W. STEWART DR.",
            "address_2": "SUITE 602",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683857",
            "telephone_number": "714-639-0414",
            "fax_number": "714-639-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOFIO",
        "first_name": "CAROLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G56506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLE",
            "last_name": "SOFIO MALCHOW",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.