Individual provider Active NPI

Mony Pheachnak Son, D.O.

  • Hospitalist Physician
  • Northridge, CA
National Provider Identifier
1710624465
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
A21867 Issued in CA
Practice address
18460 Roscoe Blvd FL 3
Northridge, CA 91325-4107
Phone
(818) 885-5480
Fax
(818) 993-1917
NPI assigned
May 15, 2022
Last updated
Sep 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X A21867 CA Primary

Addresses

Primary practice location

18460 Roscoe Blvd FL 3
Northridge, CA 91325-4107

Mailing address

3400 Data Dr
Attention: Credentialing and Payer Enrollment Dept
Rancho Cordova, CA 95670

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250705000135 CA Practitioner - Hospitalist 3577077346 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Touro Un Col of Osteopathic Medicine, New York, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

18460 Roscoe Blvd
FL 3
Northridge, CA 91325-4107
Phone (818) 885-5480

5601 De Soto Ave
Woodland Hills, CA 91367-6701
Phone (818) 719-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A21867CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation CurrentSince Jul 21, 2025 Accepting new patients
Dignity Health Medical Foundation CurrentSince Jul 21, 2025 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients

Locations

18460 Roscoe Blvd
Fl 2
Northridge, CA 91325
Phone (818) 885-5480

18460 Roscoe Blvd
Fl 3
Northridge, CA 91325
Phone (818) 885-5480

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

Organizations & group practices 4

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1710624465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "address_2": "ATTENTION: CREDENTIALING AND PAYER ENROLLMENT DEPT",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "95670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18460 ROSCOE BLVD FL 3",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913254107",
            "telephone_number": "818-885-5480",
            "fax_number": "818-993-1917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SON",
        "first_name": "MONY",
        "middle_name": "PHEACHNAK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-15",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A21867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.