NPIMap

Organization Active NPI

Susana Santiago-Soriano MD Inc

  • Pediatrics Physician
  • Los Angeles, CA
National Provider Identifier
1336296565
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A68987 Issued in CA
Legal business name
SUSANA SANTIAGO-SORIANO MD INC
Practice address
3908 Beverly Blvd
Los Angeles, CA 90004-3407
Phone
(213) 388-2508
Fax
(213) 388-5377
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Dr. Susana Visda Santiago-Soriano, M.D.NPI 1376758490
Title
President
Phone
(213) 388-2508

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X A68987 CA Primary

Addresses

Primary practice location

3908 Beverly Blvd
Los Angeles, CA 90004-3407

Mailing address

3908 Beverly Blvd
Los Angeles, CA 90004-3407
Phone (213) 388-2508

Other identifiers 1

IdentifierTypeStateIssuer
00A689870MedicaidCA

National Provider Directory

National Provider Directory

Locations

3908 Beverly Blvd
Los Angeles, CA 90004
Phone (213) 388-2508

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1336296565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043407",
            "telephone_number": "213-388-2508",
            "fax_number": "213-388-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 BEVERLY BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900043407",
            "telephone_number": "213-388-2508",
            "fax_number": "213-388-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSANA SANTIAGO-SORIANO MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO-SORIANO",
        "authorized_official_first_name": "SUSANA",
        "authorized_official_middle_name": "VISDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-388-2508",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A68987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A689870",
            "state": "CA"
        }
    ],
    "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 Jan 29, 2008; 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.