St. Michael's Neurology Medical Corp

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

20A6140 Issued in CA

Legal business name

ST. MICHAEL'S NEUROLOGY MEDICAL CORP

Practice address

1141 W Redondo Beach Blvd
Suite 207
Gardena, CA 90247-3586

Phone

(310) 225-5599

Fax

(310) 225-5660

NPI assigned

Mar 15, 2007

Last updated

Mar 10, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sherif A Dimyan, D.O.

Title

President

Phone

(310) 225-5599

Specialties & licenses 6

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tommy Van Chau, D.C.

  • Rehabilitation Chiropractor
  • Anaheim, CA
  • NPI 1497832265
  NPD
• Mary L. Dimyan, D.D.S.

  • General Practice Dentistry
  • Rancho Palos Verdes, CA
  • NPI 1417043332
  NPD

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236643200000",
    "number": "1942334958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "SUITE 207",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473586",
            "telephone_number": "310-225-5599",
            "fax_number": "310-225-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "SUITE 207",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902473586",
            "telephone_number": "310-225-5599",
            "fax_number": "310-225-5660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MICHAEL'S NEUROLOGY MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2009-03-10",
        "status": "A",
        "authorized_official_last_name": "DIMYAN",
        "authorized_official_first_name": "SHERIF",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-225-5599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CA",
            "license": "20A6410",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "20A6140",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "CA",
            "license": "20A6410",
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "CA",
            "license": "20A6410",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "CA",
            "license": "20A6410",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "CA",
            "license": "20A6410",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "20A6410",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX6461",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christa Srour
• St Monica Medical
• St. Anthony Medical Transportation, Inc.
• Ronald G St. Hill, MD
• St. Luke Medical Arts Inc (Dongjin Sung, M.D. Internal Medicine)
• Axel Sta Maria
• Robert J. Stahl, O.D.
• Amber Staine
• Isaiah Stallings
• Amorette Stanfield

• Neurology Physician in Gardena, CA
• Providers in Gardena, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2009; 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.