Jeffrey Joon-Bum So, MS, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA20727 Issued in CA

Practice address

421 N Rodeo Dr
Terrace Level, North, 2ND Floor
Beverly Hills, CA 90210-4500

Phone

(310) 274-5372

Fax

(310) 274-5380

NPI assigned

Dec 21, 2009

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.15 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

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

• Golden State Dermatology Associates, Inc.

  • Dermatology Physician
  • Walnut Creek, CA
  • NPI 1700860871
  Medicare reassignment Care Compare group
• Golden State Dermatology Associates, Inc.

  • Ambulatory Surgical Clinic/Center
  • Fresno, CA
  • NPI 1235738576
  NPD
• Moy-Fincher-Chipps Surgery Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Beverly Hills, CA
  • NPI 1144552647
  NPD (past)

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1659600799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 N RODEO DR",
            "address_2": "TERRACE LEVEL, NORTH, 2ND FLOOR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104500",
            "telephone_number": "310-274-5372",
            "fax_number": "310-274-5380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 N RODEO DR",
            "address_2": "TERRACE LEVEL, NORTH, 2ND FLOOR",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104500",
            "telephone_number": "310-274-5372",
            "fax_number": "310-274-5380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "JEFFREY",
        "middle_name": "JOON-BUM",
        "name_prefix": "Mr.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA20727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lashield Smith, MS
• Zoe Indigo Smith, MD
• Elliot Victor Smithson, DPT, ATC, EMT
• Snah Healthcare Software MGT
• Craig Dallas Snyder, PH.D.
• Julianne Mae Sobel, PSY.D.
• Melinda R Sobel, MFT
• Burton R. Sobelman, D.D.S.
• John Sobhani
• Kaivon Sobhani, MD

• Medical Physician Assistant in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.