Active NPI
Subir Roy, MD
- Gynecology Physician
- Los Angeles, CA
National Provider Identifier
1083622294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- A24383
- Practice address
- 1520 San Pablo St
Los Angeles, CA 90033 - Phone
- (323) 865-3979
- Fax
- (323) 265-0062
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | A24383 | CA | |
| Gynecology Physician | 207VG0400X | A24383 | CA | Primary |
Addresses
Primary practice location
1520 San Pablo St
Los Angeles, CA 90033
Mailing address
PO Box 31309
Los Angeles, CA 90031
Phone (323) 221-3270
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A243830 | Medicaid | CA | |
| 1992740450 | Other | GROUP NPI | |
| A24383 | Other | CA | STATE LICENSE |
| 00A243830 | Other | CA | BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A24383 | CA | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196899200000",
"number": "1083622294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31309",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90031",
"telephone_number": "323-221-3270",
"fax_number": "323-225-6284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1520 SAN PABLO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90033",
"telephone_number": "323-865-3979",
"fax_number": "323-265-0062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROY",
"first_name": "SUBIR",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2007-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "CA",
"license": "A24383",
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CA",
"license": "A24383",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A243830",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1992740450",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "A24383",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "00A243830",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.