Neil Ghodadra M.D. Inc

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

NEIL GHODADRA M.D. INC

Practice address

10780 Santa Monica Blvd
Suite 210
Los Angeles, CA 90025-4749

Phone

(310) 929-4787

NPI assigned

Sep 9, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Neil S. Ghodadra, MD

Title

Physician/Director

Phone

(678) 596-1344

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646179200000",
    "number": "1164979803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8636",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913728636",
            "telephone_number": "678-596-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10780 SANTA MONICA BLVD",
            "address_2": "SUITE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254749",
            "telephone_number": "310-929-4787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL GHODADRA M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-09",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A",
        "authorized_official_last_name": "GHODADRA",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PHYSICIAN/DIRECTOR",
        "authorized_official_telephone_number": "678-596-1344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.