Sud Specialty Group - Ca

Organization Active NPI Addiction Medicine (Psychiatry & Neurology) Physician · Santa Clara, CA

NPI 1972138238 · NPPES record last updated Apr 23, 2026

Key facts

NPI
1972138238
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X
Legal business name
SUD SPECIALTY GROUP - CA
Practice address
4633 Old Ironsides Dr Ste 304
Santa Clara, CA 95054-1846
Phone
(323) 205-7088
Fax
(866) 277-9071
NPI assigned
Mar 6, 2020
Organization subpart
No

Authorized official

Name
Gabriel Diop
Title
Authorized Agent
Phone
(323) 205-7088

Practitioners 1,487

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

View all 1,487

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230412001370 CA Part B Supplier - Clinic/Group Practice 9537534177 Receives reassigned benefits from 1,461 practitioners
Practice locations: Santa Clara, CA; Santa Monica, CA

National Provider Directory

Locations

4470 W Sunset Blvd
Ste 107
Los Angeles, CA 90027
Phone (323) 701-0371

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

312 Arizona Ave
Santa Monica, CA 90401
Phone (714) 455-9650

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YA0400X
Addiction (Substance Use Disorder) Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TA0400X
Cognitive & Behavioral Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TB0200X
Counseling Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TC1900X
Clinical Social Worker
Group: 193200000X MULTI-SPECIALTY GROUP
1041C0700X
Marriage & Family Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
106H00000X
Case Manager/Care Coordinator
Group: 193200000X MULTI-SPECIALTY GROUP
171M00000X
Addiction Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QA0401X
Addiction Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RA0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084A0401X Yes
Psychiatry Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084P0800X
Psychiatric/Mental Health Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LP0808X

Addresses

Primary practice location

4633 Old Ironsides Dr Ste 304
Santa Clara, CA 95054-1846

Mailing address

PO Box 746877
Atlanta, GA 30374-6877
Phone (323) 205-7088

Other practice location 1

5201 Great America Pkwy Ste 320
Santa Clara, CA 95054-1140
Phone (323) 205-7088

Other names

  • Rula Health Doing business as

Other providers in Santa Clara, CA

All providers in Santa Clara, CA · Addiction Medicine (Psychiatry & Neurology) Physician in California

Sources for this page

Verify at the official NPI Registry.