DR. MATTHEW DEARDORFF (NPI# 1164541181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164541181 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW DEARDORFF |
| Credential | MD, PHD |
| Practice Address |
4650 W Sunset Blvd # Ms 43 Los Angeles CA 90027-6062 |
| Practice Telephone | 8775439522 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
C168510 | CA | Allopathic & Osteopathic Physicians |
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
MD421927 | PA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | MD421927 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
4650 W SUNSET BLVD # MS 43 |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90027-6062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326653593 | Lamia Binhuwaishel | Student in an Organized Health Care Education/Training Program | 4650 Sunset Blvd, Craniofacial and Special Needs Ortho, Los Angeles, CA 90027 | 2020-09-14 |
| 1285242594 | Rocio Jimenez | Case Manager/Care Coordinator | 4650 Sunset Blvd, Mailstop #53, Los Angeles, CA 90027 | 2020-07-22 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1104450295 | Sarayana Sercarz | Marriage & Family Therapist | 4080 Woking Way, Los Angeles, CA 90027 | 2020-02-27 |
| 1457991143 | George Michaiel | Pediatrics | 4650 Sunset Blvd., Ms #54, Los Angeles, CA 90027 | 2020-01-09 |
| 1477199297 | Molly Rose Holmes | Marriage & Family Therapist | 3901 Los Feliz Boulevard, #303, Los Angeles, CA 90027 | 2019-11-27 |
| 1588206171 | Dental Help Solutions, LLC | Dentist | 4606 Hollywood Blvd, Suite A, Los Angeles, CA 90027 | 2019-10-15 |
| 1457905986 | Carmen L Ponce | Physical Therapy Assistant | 4867 Sunset Ave, Los Angeles, CA 90027 | 2019-08-01 |
| 1447729009 | Matthew Mendoza | Respiratory Therapist, Registered | 4867 Sunset Blvd, Los Angeles, Ca, Los Angeles, CA 90027 | 2018-11-13 |
| 1659856284 | Leticia Mendez | Nurse Practitioner | 1300 N Vermont Ave 606, Los Angeles, CA 90027 | 2018-09-29 |
| Find all providers in zip 90027 | ||||
| Taxonomy Code | 207SG0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Medical Genetics |
| Specialization | Clinical Genetics (M.D.) |
| A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Medical Genetics, 2007. http://www.abmg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Medical Genetics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770618589 | Linda S Cowan | Medical Genetics | 1111 W 6th St Fl 2, Los Angeles, CA 90017-1800 | 2007-02-22 |
| 1134199946 | Derek Alan Wong | Medical Genetics | 10833 Leconte Ave, Mdcc 12-334, Los Angeles, CA 90095-1732 | 2006-01-24 |
| 1568449122 | Shirley Rachel Korula | Medical Genetics | 4339 State University Dr, Diagnostic Center of Southern California, Los Angeles, CA 90032-4220 | 2005-12-27 |
| 1760765226 | Eyal M Reinstein | Medical Genetics | 8700 Beverly Blvd, Cedars Sinai Medical Center, Pact, Suite 400, Los Angeles, CA 90048 | 2011-09-21 |
| 1548548548 | Brandon Ross Colby | Medical Genetics | 10780 Santa Monica Blvd, Suite 360, Los Angeles, CA 90025-4749 | 2011-07-26 |
| 1922305036 | Linda S. Cowan, Md A Professional Corporation | Medical Genetics | 637 Lucas Ave, #205, Los Angeles, CA 90017-1912 | 2011-02-25 |
| 1306076039 | Alvaro H Serrano Russi | Medical Genetics | 4650 Sunset Blvd, Los Angeles, CA 90027-6062 | 2009-07-15 |
| 1962688853 | Sridevi Abboy | Medical Genetics | 4760 W Sunset Blvd, Los Angeles, CA 90027-6063 | 2008-01-10 |
| 1891995122 | Moin U Vera | Medical Genetics | 4650 W Sunset Blvd, Los Angeles, CA 90027 | 2007-07-24 |
| 1922206572 | University Childrens Medical Group | Medical Genetics | 4650 W Sunset Blvd, Ms# 90, Los Angeles, CA 90027-6062 | 2007-07-05 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90027 |
Please comment or provide details below to improve the information on DR. MATTHEW DEARDORFF.
| 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.