Individual provider Active NPI

Sandhya Panguluri, M.D

  • Psychiatry Physician
  • Cerritos, CA
National Provider Identifier
1962599522
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A52988 Issued in CA
Practice address
17707 Studebaker Rd
Cerritos, CA 90703-2640
Phone
(562) 402-0688
Fax
(562) 809-0185
NPI assigned
Oct 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A52988 CA Primary

Addresses

Primary practice location

17707 Studebaker Rd
Cerritos, CA 90703-2640

Mailing address

13000 Mozart Way
Cerritos, CA 90703-1379
Phone (562) 402-0688

Other identifiers 4

IdentifierTypeStateIssuer
00A529880MedicaidCA
A52988OtherCALICENSE
WA52988BOtherCAPPIN
4301056464OtherMILICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090528000337 CA Practitioner - Psychiatry 8729137443 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52988CAMDMarriage & Family Therapist
A52988CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Mental Health Current Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Apr 7, 2013 Accepting new patients
Los Angeles County Department of Mental Health CurrentSince Apr 7, 2013 Accepting new patients
Digestive and Liver Diseases Specialists, a Medical Group Inc. Past Accepting new patients

Locations

17707 Studebaker Rd
Cerritos, CA 90703
Phone (562) 402-0688

17707 Studebaker Rd
#150
Cerritos, CA 90703
Phone (310) 402-0688

10515 Balboa Blvd
Granada Hills, CA 91344
Phone (818) 486-3837

510 S Vermont Ave
Fl 19
Los Angeles, CA 90020
Phone (213) 480-3416

550 S Vermont Ave
Fl 6
Los Angeles, CA 90020
Phone (213) 351-7284

Organizations & group practices 4

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962599522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 MOZART WAY",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907031379",
            "telephone_number": "562-402-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17707 STUDEBAKER RD",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032640",
            "telephone_number": "562-402-0688",
            "fax_number": "562-809-0185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGULURI",
        "first_name": "SANDHYA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A52988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A529880",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "A52988",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPIN",
            "identifier": "WA52988B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301056464",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cerritos, CA

Sources for this page

Verify at the official NPI Registry.