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Organization
SOMA MEDICAL GROUP
Active
Organization
SOMA MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOHAIL DAVOUDIAN M.D. (MEDICAL DIRECTOR)
(310) 214-1000
Entity
Organization
Contact information
Practice address
1959 KINGSDALE AVE, REDONDO BEACH, CA 90278-3417
(310) 214-1000
(310) 214-8540
Mailing address
PO BOX 5090, REDONDO BEACH, CA 90278-9290
(310) 214-1000
(310) 214-8540
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A44878
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0059090
—
CA
Enumeration date
07/23/2006
Last updated
12/04/2008
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