Individual provider Active NPI

Patrick Adebowale Sogbein

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Van Nuys, CA
National Provider Identifier
1265404081
Registry record updated Feb 6, 2008
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Oct 20, 2014.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X
License
102908 Issued in CA
Practice address
13615 Victory Blvd
Suite136
Van Nuys, CA 91401-1737
Phone
(818) 376-1243
Fax
(818) 376-1604
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 102908 CA Primary

Addresses

Primary practice location

13615 Victory Blvd
Suite136
Van Nuys, CA 91401-1737

Mailing address

13615 Victory Blvd
Suite 136
Van Nuys, CA 91401-1737
Phone (818) 376-1243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
102908CAMDParenteral & Enteral Nutrition Supplies (DME)

Practice roles

OrganizationSpecialtyStatusNew patients
Patrick Sogbein Past Accepting new patients
Debs Medical Distributors Inc Parenteral & Enteral Nutrition Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1265404081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13615 VICTORY BLVD",
            "address_2": "SUITE 136",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011737",
            "telephone_number": "818-376-1243",
            "fax_number": "818-376-1604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13615 VICTORY BLVD",
            "address_2": "SUITE136",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914011737",
            "telephone_number": "818-376-1243",
            "fax_number": "818-376-1604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOGBEIN",
        "first_name": "PATRICK",
        "middle_name": "ADEBOWALE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CA",
            "license": "102908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.