Active NPI
Samira Soroudi
- Physician Assistant
- Pomona, CA
National Provider Identifier
1073003166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 309 E 2ND St
Pomona, CA 91766-1854 - Phone
- (909) 469-5246
- NPI assigned
- May 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
309 E 2ND St
Pomona, CA 91766-1854
Mailing address
309 E 2ND St
Pomona, CA 91766-1854
Other practice location 1
4316 Topanga Canyon Blvd
Woodland Hills, CA 91364-5238
Phone (818) 340-2221
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526256000000",
"number": "1073003166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "309 E 2ND ST",
"city": "POMONA",
"state": "CA",
"postal_code": "917661854",
"telephone_number": "909-469-5246"
}
],
"practiceLocations": [
{
"address_1": "4316 Topanga Canyon Blvd",
"address_purpose": "LOCATION",
"city": "Woodland Hills",
"state": "CA",
"postal_code": "913645238",
"country_code": "US",
"telephone_number": "818-340-2221",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOROUDI",
"first_name": "SAMIRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-14",
"last_updated": "2018-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.