Individual provider Active NPI

Semyon M Gofman, D.C.

  • Chiropractor
  • Los Angeles, CA
National Provider Identifier
1861409054
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 26055 Issued in CA
Practice address
1191 N Vermont Ave
B
Los Angeles, CA 90029-1701
Phone
(323) 668-1535
Fax
(323) 668-0666
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC 26055 CA Primary

Addresses

Primary practice location

1191 N Vermont Ave
B
Los Angeles, CA 90029-1701

Mailing address

1191 N Vermont Ave
B
Los Angeles, CA 90029-1701
Phone (323) 668-1535

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

State licenses

LicenseStateTypeSpecialty
DC 26055CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Semyon Gofman Chiropractic, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861409054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 N VERMONT AVE",
            "address_2": "B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291701",
            "telephone_number": "323-668-1535",
            "fax_number": "323-668-0666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 N VERMONT AVE",
            "address_2": "B",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291701",
            "telephone_number": "323-668-1535",
            "fax_number": "323-668-0666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFMAN",
        "first_name": "SEMYON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 26055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.