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BACCHUS MOGHADDAM MUSNGI SHWAYDER MEDICAL CORP. NPI 1174081327


NPI Information

NPI: 1174081327
Provider Name: BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP.

Doing Business As: CALMING GOAT ADDICTION MEDICINE GROUP

Classification: Psychiatry & Neurology - 2084P0800X
Entity Type: Organization

Specialization: Psychiatry

CLIA Number: 05D2236192

Address:
6801 PARK TER # 530B
LOS ANGELES, CA
ZIP 90045
Phone: (424) 376-3444
Get Directions

BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP. is a psychiatry psychiatry neurology in Los Angeles, CA. The provider is 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. BACCHUS, MOGHADDAM, MUSNGI, SHWAYDER MEDICAL CORP. NPI is 1174081327. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Calming Goat Addiction Medicine Group.

The provider's business location address is:

6801 PARK TER # 530B
LOS ANGELES, CA
ZIP 90045-543
Phone: (424) 376-3444
Fax: (424) 298-4156

The provider's authorized official is Soroya Bacchus .
The authorized official title is Coo and has the following contact phone number (310) 901-6262.

The CLIA number assigned to this NPI record is 05D2236192 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/6/2019 and was last updated on 7/29/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084A0401XPsychiatry & NeurologyAddiction MedicineNo
22084P0800XPsychiatry & NeurologyPsychiatryYes
32084P0805XPsychiatry & NeurologyGeriatric PsychiatryNo
42084P0015XPsychiatry & NeurologyPsychosomatic MedicineNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G74246OTHERCALIFORNIAMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.