Northridge Free Clinic

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A25072 Issued in CA

Legal business name

NORTHRIDGE FREE CLINIC

Practice address

8349 Reseda Blvd Ste G
Northridge, CA 91324-5914

Phone

(818) 886-7322

Fax

(818) 477-1052

NPI assigned

Oct 28, 2014

Last updated

Oct 28, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sohan Lal Dua, M.D.

Title

President

Phone

(818) 886-7322

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1414454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414454400000",
    "number": "1407251853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8349 RESEDA BLVD STE G",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245914",
            "telephone_number": "818-886-7322",
            "fax_number": "818-477-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8349 RESEDA BLVD STE G",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913245914",
            "telephone_number": "818-886-7322",
            "fax_number": "818-477-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHRIDGE FREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-28",
        "last_updated": "2014-10-28",
        "status": "A",
        "authorized_official_last_name": "DUA",
        "authorized_official_first_name": "SOHAN",
        "authorized_official_middle_name": "LAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-886-7322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A25072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nephrology Physician in Northridge, CA
• Providers in Northridge, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.