BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP. (NPI# 1174081327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174081327 |
| Entity Type | Organization |
| Organization Name | BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP. |
| Other Organization Name | CALMING GOAT ADDICTION MEDICINE GROUP |
| Practice Address |
6801 Park Ter # 530b Los Angeles CA 90045-1543 |
| Mailing Address |
Po Box 1085 Torrance CA 90505-0085 |
| Practice Telephone | 4243763444 |
| Practice Fax Number | 4242984156 |
| Mailing Telephone | 8884484628 |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | MRS. SOROYA BACCHUS (COO) |
| Authorized Official Telephone | 3109016262 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0015X |
Psychiatry & Neurology Specialization: Psychosomatic Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0805X |
Psychiatry & Neurology Specialization: Geriatric Psychiatry |
Allopathic & Osteopathic Physicians | ||
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICAL LICENSE | G74246 | 01 |
| Other Name | Type Code |
|---|---|
| Calming Goat Addiction Medicine Group | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4644 Lincoln Blvd Ste 540, Marina Del Rey, CA 902926391 | 8884484628 | 8884484628 |
| Street Address |
6801 PARK TER # 530B |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90045-1543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396388849 | Laska Dental Inc | Dentist | 5602 W Manchester Ave, Los Angeles, CA 90045 | 2019-10-28 |
| 1245889179 | Ana Arias | Physical Therapist | 6801 Terrace Drive, Suite 200, Los Angeles, CA 90045 | 2019-09-04 |
| 1144719410 | Family Dental Care 4 You | Dentist | 5602 W. Manchester Ave, Los Angeles, CA 90045 | 2018-05-02 |
| 1821504002 | Rhonda Taylor | Counselor | 8703 La Tijera Blvd Ste 201, Los Angeles, CA 90045 | 2017-12-24 |
| 1114436839 | Blanca Melisa Gomez I | Case Manager/Care Coordinator | 7423 1/4 S Sepulveda Blvd, Los Angeles, CA 90045 | 2017-09-26 |
| 1639688831 | Kalila Magbanua-stein | Counselor | 8618 La Tijera Blvd., Suite 200, Los Angeles, CA 90045 | 2017-09-20 |
| 1568984185 | Angela Mull | Marriage & Family Therapist | 8616 Latijera Blvd, Suite 307, Los Angeles, CA 90045 | 2017-07-14 |
| 1386171585 | Patricia Ann Bridewell | Registered Nurse | 5245 Concourse Drive, Suite 100, Los Angeles, CA 90045 | 2017-05-18 |
| 1679937627 | Thelese Consulting Group | Community/Behavioral Health | 8929 S. Sepulveda Blvd, Suite 400, Los Angeles, CA 90045 | 2016-04-06 |
| 1568823318 | Keith Romalis Ellison | Specialist/Technologist | One Lmu Drive, Gersten Pavilion - Athletic Training Room, Los Angeles, CA 90045 | 2016-03-08 |
| Find all providers in zip 90045 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831705383 | Joel A Badeaux, Md, A Professional Corp | Psychiatry & Neurology | 2135 Park Dr, Los Angeles, CA 90026-1919 | 2020-09-21 |
| 1205454204 | Sage Minds | Psychiatry & Neurology | 3860 Wilshire Blvd, P04-1188, Los Angeles, CA 90010 | 2020-07-07 |
| 1881241453 | Bryan Yang Md Inc | Psychiatry & Neurology | 2221 W Olympic Blvd Ste 200, Los Angeles, CA 90006-2117 | 2019-08-19 |
| 1962063859 | Nida Kichkla | Psychiatry & Neurology | 1010 N Avenue 66, Los Angeles, CA 90042-1512 | 2019-06-22 |
| 1669976874 | Pulse Tms, A Medical Corporation | Psychiatry & Neurology | 1663 Sawtelle Blvd Ste 240, Los Angeles, CA 90025-3198 | 2018-03-21 |
| 1376047670 | Sasha Getty | Psychiatry & Neurology | 11301 Wilshire Blvd Rm 6428, Los Angeles, CA 90073-1003 | 2018-03-21 |
| 1972038388 | Eric Michael | Psychiatry & Neurology | 11301 Wilshire Blvd Bldg 401, Los Angeles, CA 90073-1003 | 2017-04-23 |
| 1386175941 | Christopher Junpyo Hong | Psychiatry & Neurology | 2250 Alcazar St # 2200, Los Angeles, CA 90089-2498 | 2017-03-24 |
| 1558892638 | David Zhang | Psychiatry & Neurology | 760 Westwood Plz Ste 17-413, Los Angeles, CA 90024-5055 | 2017-03-21 |
| 1306399951 | Gotham Psychiatric PC | Psychiatry & Neurology | 5419 Hollywood Blvd Ste C172, Los Angeles, CA 90027-3480 | 2016-08-01 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90045 |
Please comment or provide details below to improve the information on BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.