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General NPI Number Information
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NPI Number | 1255985594
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Entity Type | Organization
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Legal Business Name | SOFER MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/25/2019
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 8929 WILSHIRE BLVD STE 102
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1950
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Country | US
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Telephone | 310-447-8502
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Fax |
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Provider Business Mailing Address
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Address Line | 612 CORPORATE WAY STE 2M
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City | VALLEY COTTAGE
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State | NY
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Zip | 10989-2027
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Country | US
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Telephone | 877-258-6331
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Fax | 718-362-1651
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Authorized Official
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Title or Position | OWNER
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Name | ELAZAR SOFER
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Credential | MD
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Telephone | 310-447-8502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number |
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License Number State |
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