Barry S Neidorf MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G20179 Issued in CA

Legal business name

BARRY S NEIDORF MD INC

Practice address

2080 Century Park East
Suite 1006
Los Angeles, CA 90067

Phone

(310) 277-2771

Fax

(310) 277-5184

NPI assigned

Aug 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Barry Sherwin Neidorf, MD

Title

Owner

Phone

(310) 277-2771

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1497948681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK EAST",
            "address_2": "SUITE 1006",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90067",
            "telephone_number": "310-277-2771",
            "fax_number": "310-277-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CENTURY PARK EAST",
            "address_2": "SUITE 1006",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90067",
            "telephone_number": "310-277-2771",
            "fax_number": "310-277-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY S NEIDORF MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "NEIDORF",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "SHERWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-277-2771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G20179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G201790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.