Modern Urodynamics Medical Group Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

A103568 Issued in CA

Legal business name

MODERN URODYNAMICS MEDICAL GROUP INC

Practice address

7855 Santa Monica Blvd
West Hollywood, CA 90046-5344

Phone

(323) 654-0356

Fax

(323) 297-5220

NPI assigned

Jun 11, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Scott Sparks, M.DNPI 1962609925

Title

MD

Phone

(323) 654-0356

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Stephen S Sparks, MD

  • Urology Physician
  • San Diego, CA
  • NPI 1962609925
  NPD (past) Authorized official

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1629205133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465344",
            "telephone_number": "323-654-0356",
            "fax_number": "323-297-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 SANTA MONICA BLVD",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900465344",
            "telephone_number": "323-654-0356",
            "fax_number": "323-297-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN URODYNAMICS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-11",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "323-654-0356",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "CA",
            "license": "A103568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Mizraki, MD
• Bahar Abiri Mjos, DO
• MK Dental Inc
• Gina Nan Mo
• Modern Mind Therapy
• Matthew Evan Modes, M.D.
• Nishant Modi, M.D.
• Cyrus K Mody, MD
• Aida Moeini, M.D.
• Mohammad Kashif, M.D., Inc

• Urology Physician in West Hollywood, CA
• Providers in West Hollywood, CA by specialty
• Urology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.