Provider Demographics
NPI:1447854146
Name:SOHO MEDICAL DOCTORS CALIFORNIA
Entity type:Organization
Organization Name:SOHO MEDICAL DOCTORS CALIFORNIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YERLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-369-6757
Mailing Address - Street 1:12100 WILSHIRE BLVD FL 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-7120
Mailing Address - Country:US
Mailing Address - Phone:212-369-6757
Mailing Address - Fax:212-369-3941
Practice Address - Street 1:12100 WILSHIRE BLVD FL 8
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-7120
Practice Address - Country:US
Practice Address - Phone:212-369-6757
Practice Address - Fax:212-369-3941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty