NPIMap

Organization Active NPI

Roddy S Sooferian MD Medical Corporation

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1194962399
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A76881 Issued in CA
Legal business name
RODDY S SOOFERIAN MD MEDICAL CORPORATION
Practice address
1375 Kelton Ave
#109
Los Angeles, CA 90024-5499
Phone
(310) 820-0013
Fax
(310) 207-2630
NPI assigned
Jan 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Authorized official

Name
Roddy S. Sooferian, M.D.
Title
Ceo
Phone
(310) 820-0013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A76881 CA Primary

Addresses

Primary practice location

1375 Kelton Ave
#109
Los Angeles, CA 90024-5499

Mailing address

1375 Kelton Ave
#109
Los Angeles, CA 90024-5499
Phone (310) 820-0013

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1231545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1194962399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 KELTON AVE",
            "address_2": "#109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245499",
            "telephone_number": "310-820-0013",
            "fax_number": "310-207-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 KELTON AVE",
            "address_2": "#109",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245499",
            "telephone_number": "310-820-0013",
            "fax_number": "310-207-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODDY S SOOFERIAN MD MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-10",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "SOOFERIAN",
        "authorized_official_first_name": "RODDY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-820-0013",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A76881",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 28, 2009; 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.