Southern California Neuro Medical Services Inc

Primary specialty

Brain Injury Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084P0301X

Legal business name

SOUTHERN CALIFORNIA NEURO MEDICAL SERVICES INC

Practice address

4560 Admiralty Way Ste 352
Marina del Rey, CA 90292-5448

Phone

(310) 306-8876

Fax

(310) 822-3313

NPI assigned

Apr 28, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Robert J Giombetti, MDNPI 1659445211

Title

Ceo

Phone

(310) 306-8876

Specialties & licenses 1

Addresses

Other names 1

• Robert J. Giombetti M.D. Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 6

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

• Robert Joseph Giombetti, M.D.

  • Neurology Physician
  • Marina del Rey, CA
  • NPI 1659445211

  CA

  Medicare reassignment Care Compare group Authorized official
• Silica Dioca Bungabong

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1104293067

  CA

  Medicare reassignment Care Compare group NPD
• Elizabeth Maria Elena Hernandez-Ball, NP

  • Primary Care Nurse Practitioner
  • Torrance, CA
  • NPI 1760172696

  CA

  Medicare reassignment Care Compare group NPD
• Eric Gim Lee, DC, NP

  • Family Nurse Practitioner
  • Westchester, CA
  • NPI 1245337872

  CA

  Medicare reassignment Care Compare group NPD
• Lauren Hoffman, PA

  • Physician Assistant
  • West Hollywood, CA
  • NPI 1952839508

  CA

  Medicare reassignment Care Compare group
• James A Slusher, PAC

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1831201920

  CA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631577600000",
    "number": "1447833405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY STE 352",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925448",
            "telephone_number": "310-306-8876",
            "fax_number": "310-822-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY STE 352",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925448",
            "telephone_number": "310-306-8876",
            "fax_number": "310-822-3313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5525 W Slauson Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900561047",
            "country_code": "US",
            "telephone_number": "310-642-0325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4650 Lincoln Blvd",
            "address_purpose": "LOCATION",
            "city": "Marina Del Rey",
            "state": "CA",
            "postal_code": "902926306",
            "country_code": "US",
            "telephone_number": "310-823-8911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1145 W Redondo Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Gardena",
            "state": "CA",
            "postal_code": "902473511",
            "country_code": "US",
            "telephone_number": "310-532-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA NEURO MEDICAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A",
        "authorized_official_last_name": "GIOMBETTI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-306-8876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0301X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Brain Injury Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "UNKNOWN",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "SOUTHERN CALIFORNIA NEUROLOGY MEDICAL SERVICE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4560 Admiralty Way Ste 352",
            "city": "Marina Del Rey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902925448",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "UNKNOWN",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "SOUTHERN CALIFORNIA NEUROLOGY MEDICAL SERVICE",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "4560 Admiralty Way Ste 352",
            "city": "Marina Del Rey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902925448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Robert J. Giombetti M.D.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Robert J. Giombetti M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jill L. Somerville, P.T.
• Sue Song, OTR
• Alexander Sorokurs, M.D.
• Walter Sorto
• Layla Nina Sotoodeh, PA-C
• Piyush Srivastava, MD
• St James Foundation
• R. Paul St. Amand, M.D.
• Lesley Caroline Stahl, PSY.D.
• Alan Jeffrey Steinberg, MD

• Brain Injury Medicine (Psychiatry & Neurology) Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Brain Injury Medicine (Psychiatry & Neurology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.