Individual provider Active NPI

Amy Sudhinaraset, M.D.

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
National Provider Identifier
1659762995
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
134442 Issued in CA
Practice address
1200 N State St
Ipt C3F107
Los Angeles, CA 90033-1029
Phone
(310) 405-3886
NPI assigned
Feb 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 134442 CA Primary

Addresses

Primary practice location

1200 N State St
Ipt C3F107
Los Angeles, CA 90033-1029

Mailing address

1200 N State St
Ipt C3F107
Los Angeles, CA 90033-1029
Phone (310) 405-3886

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171006001842 CA Practitioner - Obstetrics/Gynecology 1658646229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
134442CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince May 11, 2022 Accepting new patients

Locations

18300 Outer Highway 18
Apple Valley, CA 92307
Phone (760) 946-8873

300 W Huntington Dr
Arcadia, CA 91007
Phone (626) 445-4441

350 Terracina Blvd
Redlands, CA 92373
Phone (909) 335-5500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1423440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1659762995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "IPT C3F107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "310-405-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "IPT C3F107",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "310-405-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDHINARASET",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-09",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "134442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.