Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Saum Bobak Ghodoussipour, MD

Individual provider Urology Physician · NPI 1003298019

Dr. Saum Bobak Ghodoussipour, MD is an Urology in Los Angeles, California. Graduated from Temple University School of Medicine in 2013, 13 years ago. Practices with Rutgers Health-Rwj Scleroderma Program, a 387-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and New Jersey.

Years since qualifying
13
Trained at
Temple University School of Medicine
Licensed in
CA, NJ
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1516 San Pablo St Fl 5
Los Angeles, CA 90033-5313
Phone: (323) 865-3700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 25MA10839500 (NJ)
Urology Physician Taxonomy 208800000X · Licence A137177 (CA)

Record details

NPI number1003298019
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 25, 2015
Last updated in NPPESSeptember 3, 2025
Certification dateSeptember 3, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyUROLOGY
Medical schoolTEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2013 (13 years in practice)
Group practice Rutgers Health-Rwj Scleroderma Program — 387 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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