NPIMap

Individual provider Active NPI

Clark Torsten Soderlund, M.D.

  • Internal Medicine Physician
  • Torrance, CA
National Provider Identifier
1487602405
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A61166 Issued in CA
Practice address
3565 Del Amo Blvd
Torrance, CA 90503-1637
Phone
(319) 214-0811
Fax
(310) 793-4634
NPI assigned
May 4, 2006
Last updated
Nov 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A61166 CA Primary

Addresses

Primary practice location

3565 Del Amo Blvd
Torrance, CA 90503-1637

Mailing address

568 35TH St
Manhattan Beach, CA 90266-3408
Phone (310) 214-0811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040524001327 CA Practitioner - Internal Medicine 5698766970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Memorial Health SystemGroup PAC ID 9537155676, 187 clinicians

Practice addresses (Care Compare)

422 Arneill Rd B
Camarillo, CA 93010-6434
Phone (805) 383-4510

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A61166CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Memorial Health System Current Accepting new patients
Community Memorial Health System CurrentSince Aug 1, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group Internal Medicine CurrentSince Jan 1, 2004 Accepting new patients
Community Memorial Health System CurrentSince Aug 1, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Jan 1, 2004 Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

422 Arneill Rd
Ste B
Camarillo, CA 93010
Phone (805) 383-4510

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

2921 Saviers Rd
Oxnard, CA 93033
Phone (805) 487-5588

3565 Del Amo Blvd
Torrance, CA 90503

138 W Main St
Ste E
Ventura, CA 93001
Phone (805) 667-2850

147 N Brent St
Ventura, CA 93003
Phone (805) 652-5011

5855 Olivas Park Dr
Ventura, CA 93003
Phone (805) 652-5469

Interoperability endpoints

  • Direct secure messaging: clarksoderlund@cfh.allscriptsdirect.net
  • Direct secure messaging: clarksoderlund@hcpca.allscriptsdirect.net
  • Direct secure messaging: csoderlund3518280@oc.providencedirect.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1487602405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 35TH ST",
            "city": "MANHATTAN BEACH",
            "state": "CA",
            "postal_code": "902663408",
            "telephone_number": "310-214-0811",
            "fax_number": "310-793-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3565 DEL AMO BLVD",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905031637",
            "telephone_number": "319-214-0811",
            "fax_number": "310-793-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODERLUND",
        "first_name": "CLARK",
        "middle_name": "TORSTEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A61166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.