Bothyna Fayed Sedrak, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A34882 Issued in CA

Practice address

3650 South St
Suite 209
Lakewood, CA 90712-1502

Phone

(562) 634-1254

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Dignity Health

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  NPD (past)
• Long Beach Memorial Medical

  • Rehabilitation Hospital Unit
  • Long Beach, CA
  • NPI 1396791414
  NPD (past)
• University of California Irvine

  • General Acute Care Hospital
  • Lakewood, CA
  • NPI 1184655581
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750472965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST",
            "address_2": "SUITE 209",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121502",
            "telephone_number": "562-634-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 SOUTH ST",
            "address_2": "SUITE 209",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907121502",
            "telephone_number": "562-634-1254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDRAK",
        "first_name": "BOTHYNA",
        "middle_name": "FAYED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A34882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A348820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lee Schwartz
• Demaree Scobey
• Courtney A Scott, MASSAGE THERAPIST
• Monica Scudieri, THERAPIST
• Secure Medical Transit Inc.
• Sehgal Medical Corporation
• Bikram Singh Sekhon
• Sean Kylle Cabellon Selloria
• Avedik Semerjian, MD, FACP, FASN
• Prachya Senavat

• Pediatrics Physician in Lakewood, CA
• Providers in Lakewood, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.