Active NPI
Samia A Boctor, M.D.
- Internal Medicine Physician
- Northridge, CA
National Provider Identifier
1649467796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A35122
- Practice address
- 18111 Nordhoff St
Northridge, CA 91330-8270 - Phone
- (818) 677-3666
- Fax
- (818) 677-2304
- NPI assigned
- Oct 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A35122 | CA | Primary |
Addresses
Primary practice location
18111 Nordhoff St
Northridge, CA 91330-8270
Mailing address
18111 Nordhoff St
Northridge, CA 91330-8270
Phone (818) 677-3666
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EXE7010F | Other | CA | MEDI-CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A35122 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191283200000",
"number": "1649467796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18111 NORDHOFF ST",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913308270",
"telephone_number": "818-677-3666",
"fax_number": "818-677-2304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18111 NORDHOFF ST",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913308270",
"telephone_number": "818-677-3666",
"fax_number": "818-677-2304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOCTOR",
"first_name": "SAMIA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-02",
"last_updated": "2007-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A35122",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "EXE7010F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.