Individual provider Active NPI

Sofya Borisovna Tsyganovskaya, M.D.

  • Obstetrics & Gynecology Physician
  • Burbank, CA
National Provider Identifier
1336204312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A84551 Issued in CA
Practice address
1411 W Olive Ave
Suites D&E
Burbank, CA 91506-2427
Phone
(818) 653-7931
Fax
(818) 843-4622
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A84551 CA Primary

Addresses

Primary practice location

1411 W Olive Ave
Suites D&E
Burbank, CA 91506-2427

Mailing address

1161 Spazier Ave
Unit # 9
Glendale, CA 91201-3724
Phone (818) 653-7931

Other identifiers 1

IdentifierTypeStateIssuer
00A845510MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
84551CAMDClinical Social Worker
A84551CAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336204312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 SPAZIER AVE",
            "address_2": "UNIT # 9",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013724",
            "telephone_number": "818-653-7931",
            "fax_number": "818-843-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W OLIVE AVE",
            "address_2": "SUITES D&E",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062427",
            "telephone_number": "818-653-7931",
            "fax_number": "818-843-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSYGANOVSKAYA",
        "first_name": "SOFYA",
        "middle_name": "BORISOVNA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A84551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A845510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.