John J. Doherty, M.D., PH.D., Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A22240 Issued in CA

Legal business name

JOHN J. DOHERTY, M.D., PH.D., INC.

Practice address

21350 Hawthorne Blvd
Suite 258
Torrance, CA 90503-5605

Phone

(310) 540-5566

Fax

(310) 540-8577

NPI assigned

Jun 21, 2010

Organization subpart

No

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

Authorized official

Name

Dr. John J. Doherty, M.D., PH.D.

Title

President / Ceo

Phone

(310) 540-5566

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1942521208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21350 HAWTHORNE BLVD",
            "address_2": "SUITE 258",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035605",
            "telephone_number": "310-540-5566",
            "fax_number": "310-540-8577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21350 HAWTHORNE BLVD",
            "address_2": "SUITE 258",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905035605",
            "telephone_number": "310-540-5566",
            "fax_number": "310-540-8577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J. DOHERTY, M.D., PH.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-21",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "310-540-5566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A22240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5897216",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.