Organization Active NPI

Sonny Podiatry Group, Inc.

  • Podiatrist
  • Los Angeles, CA
National Provider Identifier
1235318122
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3405 Issued in CA
Legal business name
SONNY PODIATRY GROUP, INC.
Practice address
3756 Santa Rosalia Dr Ste 505
Los Angeles, CA 90008-3656
Phone
(323) 291-3963
NPI assigned
Oct 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Mr. Robert L. Williams, D.P.M.
Title
Podritrist
Phone
(323) 291-3963

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X E3405 CA Primary

Addresses

Primary practice location

3756 Santa Rosalia Dr Ste 505
Los Angeles, CA 90008-3656

Mailing address

3756 Santa Rosalia Dr Ste 505
Los Angeles, CA 90008-3656
Phone (323) 291-3963

Other identifiers 1

IdentifierTypeStateIssuer
W14068OtherCANHIC MEDICARE

National Provider Directory

National Provider Directory

Locations

3756 Santa Rosalia Dr
Ste 505
Los Angeles, CA 90008
Phone (323) 291-3963

NPI Registry JSON

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1235318122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR STE 505",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083656",
            "telephone_number": "323-291-3963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3756 SANTA ROSALIA DR STE 505",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900083656",
            "telephone_number": "323-291-3963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONNY PODIATRY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PODRITRIST",
        "authorized_official_telephone_number": "323-291-3963",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHIC MEDICARE",
            "identifier": "W14068",
            "state": "CA"
        }
    ],
    "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 Feb 28, 2008; 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.