Individual provider Active NPI

Soroush Farnoosh, MD

  • Otolaryngology Physician
  • Los Angeles, CA
National Provider Identifier
1235583287
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
A171997 Issued in CA
Practice address
1700 E Cesar E Chavez Ave Ste 2500
Los Angeles, CA 90033-2434
Phone
(323) 268-6731
Fax
(323) 268-6738
NPI assigned
Apr 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X A171997 CA Primary

Addresses

Primary practice location

1700 E Cesar E Chavez Ave Ste 2500
Los Angeles, CA 90033-2434

Mailing address

1700 E Cesar E Chavez Ave Ste 2500
Los Angeles, CA 90033-2434
Phone (323) 268-6731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210920002468 CA Practitioner - Otolaryngology 1951648542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
State University of New York Downstate Medical Center, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geoffrey Trenkle DO a Professional Medical CorporationGroup PAC ID 1759607310, 17 clinicians

Practice addresses (Care Compare)

1700 E Cesar E Chavez Ave
Suite 2500
Los Angeles, CA 90033-2434
Phone (323) 268-6731

Hospital & facility affiliations

  • Huntington Hospital Hospital, Pasadena, CA, CCN 050438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A171997CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geoffrey Trenkle DO a Professional Medical Corporation Single Specialty CurrentSince Aug 1, 2021 Accepting new patients
Michael R. Gatto MD, Inc. Single Specialty PastSince Aug 1, 2007 Accepting new patients
Cha Hollywood Medical Center, LP Past Accepting new patients
Ahmc Monterey Park Hospital LP Past Accepting new patients
Southern California Healthcare System, Inc Past Accepting new patients
Brotman Medical Center, Inc. Past Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients
Citrus Valley Medical Associates, Inc. Single Specialty PastSince Aug 2, 2021 Accepting new patients
Employee Medical Consultants PC Single Specialty Past Accepting new patients
White Memorial Medical Center Single Specialty Past Accepting new patients
Glendale Adventist Medical Center Past Accepting new patients
Samir a Shah MD Professional Corporation Single Specialty PastSince Aug 1, 2021 Accepting new patients

Locations

488 E Santa Clara St
Ste 202
Arcadia, CA 91006

1820 Fullerton Ave
Ste 115
Corona, CA 92881
Phone (951) 817-5000

1577 E Chevy Chase Dr
Ste 330
Glendale, CA 91206
Phone (818) 553-8013

14650 Aviation Blvd
Ste 200
Hawthorne, CA 90250
Phone (310) 539-2300

14650 Aviation Blvd
Ste 100
Hawthorne, CA 90250
Phone (310) 725-8505

3268 E Gage Ave
Huntington Pk, CA 90255
Phone (323) 238-3324

103 S Locust St
Inglewood, CA 90301
Phone (310) 412-3277

1045 Atlantic Ave
Ste 505
Long Beach, CA 90813
Phone (562) 437-0996

1700 E Cesar E Chavez Ave
Ste 2500
Los Angeles, CA 90033
Phone (323) 268-6731

1245 Wilshire Blvd
Ste 603
Los Angeles, CA 90017
Phone (213) 977-1215

1414 S Grand Ave
Los Angeles, CA 90015
Phone (213) 741-5271

1414 S Grand Ave
Ste 123
Los Angeles, CA 90015
Phone (213) 455-8448

1300 N Vermont Ave
Ste 605
Los Angeles, CA 90027
Phone (213) 662-8194

3737 Martin Luther King Jr Blvd
Ste 403
Lynwood, CA 90262
Phone (310) 635-2223

3737 Martin Luther King Jr Blvd
#403
Lynwood, CA 90262

433 N 4th St
Ste 212
Montebello, CA 90640
Phone (323) 238-3324

18546 Roscoe Blvd
Ste 200
Northridge, CA 91324
Phone (818) 993-1112

1180 N Indian Canyon Dr
Ste E311
Palm Springs, CA 92262
Phone (760) 320-4136

41250 12th St W
Ste C
Palmdale, CA 93551
Phone (323) 328-8059

800 Fairmount Ave
Ste 411
Pasadena, CA 91105

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1235583287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE STE 2500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332434",
            "telephone_number": "323-268-6731",
            "fax_number": "323-268-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E CESAR E CHAVEZ AVE STE 2500",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900332434",
            "telephone_number": "323-268-6731",
            "fax_number": "323-268-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNOOSH",
        "first_name": "SOROUSH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-15",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A171997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.