Modern Human MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MODERN HUMAN MD PC

Practice address

1301 20TH St Ste 550
Santa Monica, CA 90404-2054

Phone

(310) 315-0231

Fax

(310) 315-0235

NPI assigned

Sep 18, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Stephanie Tran, MDNPI 1770999450

Title

Physician

Phone

(505) 358-6070

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

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

• Stephanie Tran

  • Family Medicine Physician
  • Santa Monica, CA
  • NPI 1770999450
  Medicare reassignment NPD Authorized official
• William Arthur Pullen, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Glendale, CA
  • NPI 1104977248
  Medicare reassignment NPD
• Lewis Ringel Kanengiser, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
  • NPI 1124120787
  NPD

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1992583413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 N MAPLE DR APT 201",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902103832",
            "telephone_number": "505-358-6070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 550",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042054",
            "telephone_number": "310-315-0231",
            "fax_number": "310-315-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HUMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "505-358-6070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M Ramin Modabber, M.D.
• Jonathan Modai, MD
• Linda Modaro, L.AC.
• Modern Core Physical Therapy and Wellness
• Modern Diagnostics Medical Services
• Modern Movement Physical Therapy & Performance
• Modern Movement Physical Therapy Inc.
• Omeed Modiri, MD
• Kevin Alan Moe
• Moeiz Koshki DDS Inc

• Family Medicine Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.