Organization Active NPI

Sofya Tsyganovskaya MD Inc.

  • Specialist
  • Burbank, CA
National Provider Identifier
1386770691
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A84551 Issued in CA
Legal business name
SOFYA TSYGANOVSKAYA MD INC.
Practice address
1411 W Olive Ave
Suite D&E
Burbank, CA 91506-2427
Phone
(818) 843-1884
Fax
(818) 843-4622
NPI assigned
Feb 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sofya Tsyaganovskaya
Title
Ceo
Phone
(818) 653-7931

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X A84551 CA Primary

Addresses

Primary practice location

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

Mailing address

PO Box 5655
Glendale, CA 91221-5655
Phone (818) 559-7367

Other identifiers 1

IdentifierTypeStateIssuer
00A845510MedicaidCA

National Provider Directory

National Provider Directory

Locations

1411 W Olive Ave
Ste De
Burbank, CA 91506
Phone (818) 843-1884

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386770691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5655",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912215655",
            "telephone_number": "818-559-7367",
            "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": "SUITE D&E",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062427",
            "telephone_number": "818-843-1884",
            "fax_number": "818-843-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOFYA TSYGANOVSKAYA MD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TSYAGANOVSKAYA",
        "authorized_official_first_name": "SOFYA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-653-7931"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.