Active NPI
Victoria Soekamto, NURSE PRACTITIONER
- Nurse Practitioner
- S. El Monte, CA
National Provider Identifier
1679860654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- NP20011
- Practice address
- 9573 Garvey Ave.
Suite #17
S. El Monte, CA 91733-4606 - Phone
- (626) 454-1801
- Fax
- (626) 454-2203
- NPI assigned
- Jun 29, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | NP20011 | CA | |
| Pediatrics Physician | 208000000X | NP20011 | CA | |
| Nurse Practitioner | 363L00000X | NP20011 | CA | Primary |
Addresses
Primary practice location
9573 Garvey Ave.
Suite #17
S. El Monte, CA 91733-4606
Mailing address
9573 Garvey Ave
Suite #17
S. El Monte, CA 91733-4606
Phone (626) 454-1801
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP20011 | CA | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Julius C Kpaduwa Medical Corporation | Past | Accepting new patients | |
| Julius C Kpaduwa Medical Corporation | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- El Monte, CA
- NPI 1396893723
-
- Obstetrics Physician
- City of Industry, CA
- NPI 1790975258
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309305600000",
"number": "1679860654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9573 GARVEY AVE",
"address_2": "SUITE #17",
"city": "S. EL MONTE",
"state": "CA",
"postal_code": "917334606",
"telephone_number": "626-454-1801",
"fax_number": "626-454-2203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9573 GARVEY AVE.",
"address_2": "SUITE #17",
"city": "S. EL MONTE",
"state": "CA",
"postal_code": "917334606",
"telephone_number": "626-454-1801",
"fax_number": "626-454-2203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOEKAMTO",
"first_name": "VICTORIA",
"credential": "NURSE PRACTITIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-29",
"last_updated": "2011-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "CA",
"license": "NP20011",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "NP20011",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "NP20011",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in S. El Monte, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.