Soroya Bacchus MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

G74246 Issued in CA

Legal business name

SOROYA BACCHUS MD

Practice address

2730 Wilshire Blvd
Suite 660
Santa Monica, CA 90403-4743

Phone

(310) 829-4640

NPI assigned

Jun 22, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Soroya Bacchus, MD

Title

Owner

Phone

(310) 829-4640

Specialties & licenses 1

Addresses

Tax ID family

Soroya Bacchus MD Apc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Soroya Bacchus, MD a Professional Medical Corporation

  • Psychiatry Physician
  • Los Angeles, CA
  • NPI 1841892965
  NPD tax ID

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1285084111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "SUITE 660",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743",
            "telephone_number": "310-829-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 WILSHIRE BLVD",
            "address_2": "SUITE 660",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034743",
            "telephone_number": "310-829-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOROYA BACCHUS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "BACCHUS",
        "authorized_official_first_name": "SOROYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-829-4640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "G74246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennylaine Soonthonthum, MSN, APRN, PMHNP-BC
• Emil Soorani, M.D.
• Sophie M. Andriaschuk, M.D., Inc.
• Clinton John Soppe, M.D.
• Ruth Adina Sorotzkin, M.D.
• Christopher Sorrells, OTR
• Brian Jossue Sorto, DNP, AGACNP-BC
• Alexander Soto
• Melanie Anne Soto
• Soulaire Wellness

• Psychiatry Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.