SOMA MEDICAL GROUP
NPI 1063434900
Internal Medicine in Redondo Beach, CA

Q: What is Soma Medical Group's NPI number?

The NPI number for Soma Medical Group is 1063434900. It was assigned to this organization in the NPPES registry on July 23, 2006.

Q: What is Soma Medical Group's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since July 23, 2006CLIA 05D0880808 · Waiver

1959 KINGSDALE AVE, REDONDO BEACH, CA 90278(310) 214-1000(310) 214-8540 Get Directions Write a Review

NPPES record last updated: December 4, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Soma Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOMA MEDICAL GROUP (NPI 1063434900) is a healthcare organization registered as an internal medicine in Redondo Beach, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through December 22, 2027 and lists Sohail Davoudian, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1063434900

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameSOMA MEDICAL GROUP

Location Address1959 KINGSDALE AVERedondo Beach, CA 90278-3417

Mailing AddressPo Box 5090Redondo Beach, CA 90278-9290 · (310) 214-1000 · Fax (310) 214-8540

Phone(310) 214-1000

Fax(310) 214-8540

Organization SubpartNo

Authorized OfficialSohail DavoudianMedical Director · (310) 214-1000

Enumeration DateJuly 23, 2006

Last NPPES UpdateDecember 4, 2008

✔ NPI 1063434900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A44878

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1959 KINGSDALE AVE, Redondo Beach, CA 90278

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Other Identifiers 3

MedicaidGR0059090CA

Medicare UPINE07472CA

Medicare ID-Type UnspecifiedW12290CA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0880808

Soma Medical Group · Redondo Beach, CA

Active · expires Dec 22, 2027

CLIA Number05D0880808

Laboratory TypePhysician Office

Certificate Effective DateDecember 23, 2025

Certificate Expiration DateDecember 22, 2027

Laboratory DirectorSohail M. Davoudian

Laboratory Phone(310) 214-1000

Laboratory LocationSoma Medical Group1959 Kingsdale Ave, Redondo Beach, CA 90278

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIMBERLY MAY ESTACIO FNP-C

Nurse Practitioner (Family)