1740514066 NPI number — SOHEIL NAJIBI, MD PHD

Table of content: (NPI 1740514066)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740514066 NPI number — SOHEIL NAJIBI, MD PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOHEIL NAJIBI, MD PHD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740514066
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1709
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90053-1709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-582-7475
Provider Business Mailing Address Fax Number:
310-582-7481

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 SANTA MONICA BLVD
Provider Second Line Business Practice Location Address:
STE 1090
Provider Business Practice Location Address City Name:
SANTA MONICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90404-2102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-582-7475
Provider Business Practice Location Address Fax Number:
310-582-7481
Provider Enumeration Date:
09/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
NAJIBI
Authorized Official First Name:
SOHEIL
Authorized Official Middle Name:
Authorized Official Title or Position:
MD, PRESIDENT
Authorized Official Telephone Number:
310-582-7475

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  A88147 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A88147 . This is a "LICENS NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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