1649998022 NPI number — K SOMANATH MD INC

Table of content: (NPI 1649998022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649998022 NPI number — K SOMANATH MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
K SOMANATH MD INC
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:
PSYCHIATRY TREATMENT CENTERS
Provider Other Organization Name Type Code:
3
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:
1649998022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3641 MEADOWGLEN CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT CHARLES
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63303-6678
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
424-588-5350
Provider Business Mailing Address Fax Number:
844-440-5653

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6464 W SUNSET BLVD STE 740
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90028-8009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-588-5350
Provider Business Practice Location Address Fax Number:
844-440-5653
Provider Enumeration Date:
08/22/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOMANATH
Authorized Official First Name:
KEERTHAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
512-659-7831

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0804X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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