Organization Active NPI

Amor Srikureja, M.D. a Medical Corporation

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1881936433
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AMOR SRIKUREJA, M.D. A MEDICAL CORPORATION
Practice address
2021 Santa Monica Blvd. Suite 540E
Santa Monica, CA 90404
Phone
(310) 828-9501
Fax
(310) 828-5052
NPI assigned
Mar 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Authorized official

Name
Dr. Amornchit Srikureja, M.D.NPI 1588692214
Title
Ceo
Phone
(310) 828-9501

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2021 Santa Monica Blvd. Suite 540E
Santa Monica, CA 90404

Mailing address

2021 Santa Monica Blvd. Suite 540E
Santa Monica, CA 90404
Phone (310) 828-9501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130412000351 CA Part B Supplier - Clinic/Group Practice 9537305727 Receives reassigned benefits from 1 practitioner
Practice locations: Santa Monica, CA

National Provider Directory

National Provider Directory

Locations

2021 Santa Monica Blvd
Ste 504E
Santa Monica, CA 90404

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1881936433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD. SUITE 540E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-828-9501",
            "fax_number": "310-828-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD. SUITE 540E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-828-9501",
            "fax_number": "310-828-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMOR SRIKUREJA, M.D. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "SRIKUREJA",
        "authorized_official_first_name": "AMORNCHIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-828-9501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.