Soorena Fatehchehr MD Inc

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

Legal business name

SOORENA FATEHCHEHR MD INC

Practice address

529 E 10TH St FL 2
Long Beach, CA 90813-4508

Phone

(562) 491-9047

Fax

(562) 491-9251

NPI assigned

Jan 2, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Soorena Fatehchehr, MDNPI 1891081253

Title

Ceo

Phone

(310) 869-3212

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Soorena Fatehchehr, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Long Beach, CA
  • NPI 1891081253
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1750920153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 GLENCOE AVE UNIT 1114",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925660",
            "telephone_number": "310-869-3212",
            "fax_number": "949-502-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 E 10TH ST FL 2",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134508",
            "telephone_number": "562-491-9047",
            "fax_number": "562-491-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOORENA FATEHCHEHR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "FATEHCHEHR",
        "authorized_official_first_name": "SOORENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-869-3212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.