Timothy Socheta So, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA13276 Issued in CA

Practice address

1627 E. Anaheim Street
Long Beach, CA 90813-3809

Phone

(562) 437-0373

Fax

(562) 591-9646

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Serenity Care Health Group

  • Federally Qualified Health Center (FQHC)
  • Long Beach, CA
  • NPI 1245623156
  Medicare reassignment NPD
• Community Outreach Medical Services

  • Community Health Clinic/Center
  • Santa Ana, CA
  • NPI 1487947842
  NPD (past)
• Lina Suchov a Professional Psychology Corporation

  • Psychologist
  • Encino, CA
  • NPI 1588085328
  NPD (past)
• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1073628202
  NPD (past)
• Molina Healthcare of California

  • Family Medicine Physician
  • Sacramento, CA
  • NPI 1841305075
  NPD (past)
• Molina Medical Centers

  • Family Medicine Physician
  • Colton, CA
  • NPI 1114032448
  NPD (past)
• San Martin Deporres Medical Group

  • Geriatric Medicine (Family Medicine) Physician
  • Santa Ana, CA
  • NPI 1861513525
  NPD (past)
• Tracy D. Charles M.D. Inc

  • Anesthesiology Physician
  • Temecula, CA
  • NPI 1639341944
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1811901960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "STE #100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "562-499-6191",
            "fax_number": "562-499-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 E. ANAHEIM STREET",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133809",
            "telephone_number": "562-437-0373",
            "fax_number": "562-591-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SO",
        "first_name": "TIMOTHY",
        "middle_name": "SOCHETA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA13276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA13276",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corinne Snyder
• Renee Snyder, M.P.T.
• Shannon Snyder
• Teresa Cobian Snyder, M.S., CCC-SLP
• Mali So
• Vannarith So, MD, MPH
• Natalie Sobel
• Serap Sobnosky, MD
• Jennifer Suzanne Sobrero
• Socal Driven LLC

• Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.