Healthcare Provider Details

I. General information

NPI: 1134375223
Provider Name (Legal Business Name): VINOD SODHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 N WETHERLY DR
BEVERLY HILLS CA
90211-1813
US

IV. Provider business mailing address

132 N WETHERLY DR
BEVERLY HILLS CA
90211-1109
US

V. Phone/Fax

Practice location:
  • Phone: 213-807-4300
  • Fax:
Mailing address:
  • Phone: 213-807-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberA34742
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberA347420
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License NumberA347420
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberA347420
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA34742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: