Organization Active NPI

Khaldoun S. Sroujieh, MD, Inc

  • Cardiovascular Disease Physician
  • Los Angeles, CA
National Provider Identifier
1467544742
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
KHALDOUN S. SROUJIEH, MD, INC
Practice address
1300 North Vermont Avenue
Suite 401
Los Angeles, CA 90027-6005
Phone
(323) 664-6535
Fax
(323) 664-2964
NPI assigned
Sep 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Authorized official

Name
Dr. Khaldoun S. Sroujieh, M.D.NPI 1396828844
Title
President
Phone
(323) 664-6535

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
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

1300 North Vermont Avenue
Suite 401
Los Angeles, CA 90027-6005

Mailing address

1300 North Vermont Avenue
Suite 401
Los Angeles, CA 90027-6005
Phone (323) 664-6535

Other identifiers 1

IdentifierTypeStateIssuer
00A335080MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080521000870 CA Part B Supplier - Clinic/Group Practice 9830268473 Receives reassigned benefits from 1 practitioner
Practice locations: Burbank, CA; Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1300 N Vermont Ave
Ste 409
Los Angeles, CA 90027
Phone (323) 664-6535

Practitioners & affiliated clinicians

Practitioners 1

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": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1467544742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 NORTH VERMONT AVENUE",
            "address_2": "SUITE 401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276005",
            "telephone_number": "323-664-6535",
            "fax_number": "323-664-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 NORTH VERMONT AVENUE",
            "address_2": "SUITE 401",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276005",
            "telephone_number": "323-664-6535",
            "fax_number": "323-664-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHALDOUN S. SROUJIEH, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "SROUJIEH",
        "authorized_official_first_name": "KHALDOUN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-664-6535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A335080",
            "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 Aug 31, 2022; 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.