Roots Addiction and Psychiatry Medical Group, PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

ROOTS ADDICTION AND PSYCHIATRY MEDICAL GROUP, PC

Practice address

3939 Atlantic Ave Ste 100
Long Beach, CA 90807-3529

Phone

(562) 473-0825

Fax

(562) 473-0825

NPI assigned

May 26, 2023

Organization subpart

No

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

Authorized official

Name

Andrei Dokukin, MDNPI 1770715575

Title

Ceo

Phone

(562) 304-9592

Specialties & licenses 2

Addresses

Practitioners 1

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

• Andrei N Dokukin, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Long Beach, CA
  • NPI 1770715575

  Addiction Medicine

  NPD Authorized official

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

{
    "created_epoch": "1685059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1205529252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 ATLANTIC AVE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073529",
            "telephone_number": "562-473-0825",
            "fax_number": "562-473-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 ATLANTIC AVE STE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073529",
            "telephone_number": "562-473-0825",
            "fax_number": "562-473-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS ADDICTION AND PSYCHIATRY MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-26",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "DOKUKIN",
        "authorized_official_first_name": "ANDREI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-304-9592",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Addiction 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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Xavier Dental Corp
• Ronnies House
• Domonique Hualani Rood
• Karen Roos, PHD, MSPT, ATC
• Roots Addiction & Psychiatry Medical Group, PC
• Roots Psychological Group, PC
• Roots TMS, LLC
• Roots, Inc.
• Deyanira Roque
• Johanna P Roque

• Psychiatry Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.