DR. SHIRLEY RACHEL KORULA (NPI# 1568449122) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568449122 |
| Entity Type | Individual |
| Full Name | DR. SHIRLEY RACHEL KORULA |
| Credential | M.D. |
| Practice Address |
4339 State University Dr Diagnostic Center of Southern California Los Angeles CA 90032-4220 |
| Practice Telephone | 3232228090 |
| Practice Fax Number | 3232223018 |
| Mailing Telephone | 3232228090 |
| Mailing Fax Number | 3232223018 |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2007-07-08 |
| NPI Deactivation Date | 03/25/2006 |
| NPI Reactivation Date | 2006-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
A39721 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4339 STATE UNIVERSITY DR DIAGNOSTIC CENTER OF SOUTHERN CALIFORNIA |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90032-4220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700034352 | Michelle Amisola Cuevas | Psychologist | 4339 State University Dr, Los Angeles, CA 90032-4220 | 2008-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821615220 | Sarah Payne | Counselor | 3217 North Eastern Ave, Los Angeles, CA 90032 | 2020-07-01 |
| 1063867448 | Paul Mendez | Social Worker | 4099 North Mission Rd, Los Angeles, CA 90032 | 2016-05-04 |
| 1700245297 | Diana Truong | Pharmacist | 3333 S Figueroa St Unit 3, Los Angeles, CA 90032 | 2016-02-12 |
| 1114308400 | Francis Alvin Perez | Specialist/Technologist | 5035 O'sullivan Dr., Los Angeles, CA 90032 | 2015-06-12 |
| 1417351370 | Comfort Providers Group Hospice,inc. | Hospice Care, Community Based | 4943 Renovo Street., Los Angeles, CA 90032 | 2014-10-21 |
| 1679917652 | Principles Inc. | Substance Abuse Rehabilitation Facility | 3217 N Eastern Ave, Los Angeles, CA 90032 | 2013-04-22 |
| 1679851885 | Joshua M Arellano | Physical Therapist | 3836 Hellman Ave, Los Angeles, CA 90032 | 2011-07-22 |
| 1346532322 | Brenda Ramires-torres | Counselor | 2457 Endicott Street, Los Angeles, CA 90032 | 2011-05-09 |
| 1063716561 | Lisa Erin Gold | Social Worker | 4099 N. Mission Road, Los Angeles, CA 90032 | 2010-12-27 |
| 1992013320 | Mary Luikens | Counselor | 4099 N. Misson Rd., Los Angeles, CA 90032 | 2010-09-20 |
| Find all providers in zip 90032 | ||||
| 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 |
|---|---|---|---|---|
| 1164541181 | Matthew Deardorff | Medical Genetics | 4650 W Sunset Blvd # Ms 43, Los Angeles, CA 90027-6062 | 2007-03-29 |
| 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 |
| 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 | 90032 |
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| 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.