Katie K Soe

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

A176474 Issued in CA

Practice address

3208 Santa Anita Ave Ste 200
El Monte, CA 91733-1304

Phone

(626) 454-1990

NPI assigned

Apr 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Locations

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Fontana, CA
  • NPI 1316463763
  NPD

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1881156925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3208 SANTA ANITA AVE STE 200",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917331304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 SANTA ANITA AVE STE 200",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917331304",
            "telephone_number": "626-454-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOE",
        "first_name": "KATIE",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A176474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myra Denice Smith, MS
• Social Model Recovery Systems (Bimini recovery home)
• Social Model Recovery Systems Inc
• Social Model Recovery Systems, Inc. (Omni Center)
• Social Model Recovery Systems, Inc. (Mid Valley Outpatient Services)
• Nyun Nyun Soe
• Sole Proprietor
• Marcos Soliman
• Mona Soliman, DDS
• Nabil K Soliman, MD

• Geriatric Medicine (Family Medicine) Physician in El Monte, CA
• Providers in El Monte, CA by specialty
• Geriatric Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.