Shahram Soroudi, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

55938 Issued in CA

Practice address

23357 Pacific Coast Hwy
Malibu, CA 90265-4957

Phone

(310) 456-9059

NPI assigned

Dec 12, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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.

• Super Care Drugs Inc

  • Pharmacy
  • Malibu, CA
  • NPI 1942282884
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407917669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 SHADYBROOK DR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902102031",
            "telephone_number": "310-927-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23357 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902654957",
            "telephone_number": "310-456-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOROUDI",
        "first_name": "SHAHRAM",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "55938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Sniffen, ATC
• Soba Living LLC
• Soba Outpatient and Recovery LLC
• Socal Psych, Inc
• Socal Recovery Centers, Inc.
• William David Stanley, MD
• Star & Sky Physical Therapy, Inc
• Robin Steinberg, LMFT
• Barbara Stern, R.N.
• Susan J Stiffelman, MFT

• Pharmacist in Malibu, CA
• Providers in Malibu, CA by specialty
• Pharmacist 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.