Serge Obukhoff, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

B65490 Issued in CA

Practice address

6200 Wilshire Blvd
Los Angeles, CA 90048-5801

Phone

(323) 933-3200

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Serge Obukhov Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Serge Obukhov, M.D. PC

  • Neurological Surgery Physician
  • Garden Grove, CA
  • NPI 1386968543
  NPD (past) Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295882496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27159 SEA VISTA DR",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654436",
            "telephone_number": "310-457-7421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-933-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBUKHOFF",
        "first_name": "SERGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "B65490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SERGE",
            "last_name": "OBUKHOV",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Obler, MD
• Daniel H Oblitas, M.D.
• Kendall Brooke Obra
• Veronica Obregon, LCSW
• Valentina Obreja, NP
• Kingsley Obute
• Mariah Oca
• Adolfo Amador Ocampo
• Alfonso Ocampo
• Christine Chaiya Alajan Ocampo, RPT

• Neurological Surgery Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.