David L Sodaro, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A39157 Issued in CA

Practice address

1451 Irvine Blvd
Tustin, CA 92780-3804

Phone

(714) 838-8878

Fax

(714) 838-8988

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• David Leigh Sodaro Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1659460947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17360 BROOKHURST ST",
            "address_2": "ATTN: MCMF - CREDENTIALING DEPARTMENT",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927083720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803804",
            "telephone_number": "714-838-8878",
            "fax_number": "714-838-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODARO",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A39157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "SODARO",
            "middle_name": "LEIGH",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Family Medicine Physician in Tustin, CA
• Providers in Tustin, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.