Southern California Head & Neck Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

G26964 Issued in CA

Legal business name

SOUTHERN CALIFORNIA HEAD & NECK MEDICAL GROUP

Practice address

1301 20TH St Ste 300
Santa Monica, CA 90404-2087

Phone

(310) 829-7792

Fax

(310) 829-4136

NPI assigned

Aug 9, 2006

Organization subpart

No

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

Authorized official

Name

David Michael Butler, M.D.

Title

Partner

Phone

(310) 829-7792

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1235149170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 300",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042087",
            "telephone_number": "310-829-7792",
            "fax_number": "310-829-4136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 300",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042087",
            "telephone_number": "310-829-7792",
            "fax_number": "310-829-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA HEAD & NECK MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "310-829-7792",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G26964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Anne Soto
• Soulaire Wellness
• Soultice Health Moves
• Source Surgery Center LLC
• Cibele Sousa
• Southern California Head & Neck Surgery Center
• Southern California Head Neck Imaging Center
• Southern California Medical Gastroenterology Group, Inc.
• Southern California Mobility, Inc.
• Sowa Wellness Center Inc

• Specialist in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.