Individual provider Active NPI

William Woodrow Sutherling, M.D.

  • Neurology Physician
  • Pasadena, CA
National Provider Identifier
1285677096
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G45896 Issued in CA
Practice address
10 Congress St
Suite 505
Pasadena, CA 91105-3045
Phone
(626) 792-7300
Fax
(626) 792-7336
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X G45896 CA Primary

Addresses

Primary practice location

10 Congress St
Suite 505
Pasadena, CA 91105-3045

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other identifiers 2

IdentifierTypeStateIssuer
00G458960MedicaidCA
G45896OtherCAMEDICAL LICENSE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G45896CAMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1285677096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631",
            "fax_number": "626-792-7336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CONGRESS ST",
            "address_2": "SUITE 505",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053045",
            "telephone_number": "626-792-7300",
            "fax_number": "626-792-7336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLING",
        "first_name": "WILLIAM",
        "middle_name": "WOODROW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G45896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G458960",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "G45896",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.