Individual provider Active NPI

Selam Ghebrekidus Ogbalidet, MD

  • Surgery Physician
  • West Hollywood, CA
National Provider Identifier
1841002714
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
200401 Issued in CA
Practice address
9201 W Sunset Blvd Ste 305
West Hollywood, CA 90069-3704
Phone
(877) 829-9823
NPI assigned
Jan 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 200401 CA Primary

Addresses

Primary practice location

9201 W Sunset Blvd Ste 305
West Hollywood, CA 90069-3704

Mailing address

9201 W Sunset Blvd Ste 305
West Hollywood, CA 90069-3704
Phone (877) 829-9823

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200401CAMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1841002714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 W SUNSET BLVD STE 305",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900693704",
            "telephone_number": "877-829-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W SUNSET BLVD STE 305",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900693704",
            "telephone_number": "877-829-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBALIDET",
        "first_name": "SELAM",
        "middle_name": "GHEBREKIDUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "200401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.