Bacchus, Moghaddam, Musngi, Shwayder Medical Corp.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP.

Practice address

6801 Park Ter # 530B
Los Angeles, CA 90045-1543

Phone

(424) 376-3444

Fax

(424) 298-4156

NPI assigned

Mar 6, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Soroya Bacchus, MDNPI 1407953029

Title

Coo

Phone

(310) 901-6262

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Calming Goat Addiction Medicine Group Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Soroya Montez Bacchus, M.D.

  • Psychiatry Physician
  • Los Angeles, CA
  • NPI 1407953029
  NPD (past) Authorized official

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1174081327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1085",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905050085",
            "telephone_number": "888-448-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 PARK TER # 530B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451543",
            "telephone_number": "424-376-3444",
            "fax_number": "424-298-4156"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4644 Lincoln Blvd Ste 540",
            "address_purpose": "LOCATION",
            "city": "Marina Del Rey",
            "state": "CA",
            "postal_code": "902926391",
            "country_code": "US",
            "telephone_number": "888-448-4628",
            "fax_number": "888-448-4628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "SOROYA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "310-901-6262",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0015X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychosomatic Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G74246",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Calming Goat Addiction Medicine Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Bacall
• Marife Bacani
• Anyssa Bacazar
• Cristina Bacca, AMFT
• Stephen Alexander Baccari, NP
• Soroya Montez Bacchus, M.D.
• Eddamarina Bacelis
• Jasmine Bacerdo, RN
• Andrew J Bach, D.O.
• Carrie Bach, RN, PHN

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.