Individual provider Active NPI

Edmond Gidon Sarraf, M.D.

  • Pediatric Adolescent Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1295874022
Registry record updated Apr 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
A87551 Issued in CA
Practice address
955 Carrillo Dr Ste 210
Los Angeles, CA 90048
Phone
(310) 888-7778
Fax
(310) 888-7732
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A87551 CA
Pediatric Adolescent Medicine Physician 2080A0000X A87551 CA Primary

Addresses

Primary practice location

955 Carrillo Dr Ste 210
Los Angeles, CA 90048

Mailing address

PO Box 846
Beverly Hills, CA 90213
Phone (310) 888-7778

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A87551CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Gems, P.C. Pediatrics Current Accepting new patients
Covid Testing Labs LLC Current Accepting new patients
Summerlin Hospital Medical Center L L C Past Accepting new patients
The Regents of the University of California Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

955 Carrillo Dr
Ste 210
Los Angeles, CA 90048
Phone (310) 888-7778

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1295874022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 846",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90213",
            "telephone_number": "310-888-7778",
            "fax_number": "310-888-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CARRILLO DR STE 210",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-888-7778",
            "fax_number": "310-888-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARRAF",
        "first_name": "EDMOND",
        "middle_name": "GIDON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A87551",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A87551",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 13, 2017; 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.