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Export Provider Record NPI 1306870548
Oleg Yuryevich SorokoumovMD
Active
NPI Number1306870548
NPI TypeNPI-1 Individual
SpecialtyInternal Medicine, Critical Care Medicine
Provider Details
NPI1306870548
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2006-07-11
Last Updated2015-12-10
Mailing Address5555 Grossmont Center Dr
La Mesa, CA 91942-3019
United States
Phone: (858) 248-3634 | Fax: (858) 751-0588
📍 View Map
Primary Practice Address5555 Grossmont Center Dr, Sharp Grossmont Hospital
La Mesa, CA 91942
United States
Phone: (858) 248-3634
📍 View Map
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDCA1306870548-
Other (non-Medicare)CAFY773MediCare
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No207RC0200X – Internal Medicine, Critical Care MedicineWI48325
Yes207RC0200X – Internal Medicine, Critical Care MedicineCAC55036
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About NPI 1306870548

Oleg Yuryevich Sorokoumov MD is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1306870548. The primary specialty listed is Internal Medicine, Critical Care Medicine. The provider is located in La Mesa, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-11. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1306870548?

NPI 1306870548 belongs to Oleg Yuryevich Sorokoumov MD, a Internal Medicine, Critical Care Medicine in La Mesa, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1306870548 active?

The current status of NPI 1306870548 in the NPPES registry is Active. The record was last updated on 2015-12-10.

What specialty is NPI 1306870548?

NPI 1306870548 is classified under the taxonomy Internal Medicine, Critical Care Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1306870548?

You can verify NPI 1306870548 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1306870548?

The primary practice address on file for NPI 1306870548 is 5555 Grossmont Center Dr, La Mesa, CA 91942. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1306870548 issued?

NPI 1306870548 was first issued (enumerated) on 2006-07-11. The NPPES record was last updated on 2015-12-10.

Practice Location Map

Oleg Yuryevich Sorokoumov is located at 5555 Grossmont Center Dr, La Mesa, CA. Use the map below to find directions or verify the practice location.

📍 5555 Grossmont Center Dr, La Mesa, CA 91942  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Oleg Yuryevich Sorokoumov. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1306870548. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Internal Medicine, Critical Care Medicine48325WI
Internal Medicine, Critical Care MedicineC55036CA
Data Verified from CMS NPPES Last synced: 2026-08-05 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162