Joe Mawad, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · San Bernardino, CA
NPI 1003140948 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1003140948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- A109432 (CA)
- Practice address
- 1800 Western Ave Ste 204
San Bernardino, CA 92411 - Phone
- (909) 474-9952
- Fax
- (909) 474-9951
- NPI assigned
- Sep 24, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Owned or controlled facilities with NPI records 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Community Hospital of San Bernardino |
Hospital | Corporate Director | Feb 14, 2017 |
| San Bernardino Community Hospital |
Hospital | Corporate Director | Feb 1, 2015 |
| Community Hospital of San Bernardino |
Skilled nursing facility | Corporate Director | Feb 1, 2015 |
| Community Convalescent Center of San Bernardino |
Skilled nursing facility | Corporate Director | Feb 14, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130314000199 | CA | Practitioner - Obstetrics/Gynecology | 4082859301 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles (4 of 5)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kvara LLC | Obstetrics & Gynecology | Current | Accepting new patients |
| Hospital of Barstow Inc | Past | Accepting new patients | |
| Community Hospital of San Bernardino | Past | Accepting new patients | |
| Dignity Health | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | A109432 | CA | Yes |
Addresses
Primary practice location
1800 Western Ave Ste 204
San Bernardino, CA 92411
Mailing address
1800 Western Ave Ste 204
San Bernardino, CA 92411-1353
Phone (909) 474-9952
Other practice location 1
742 W Highland Ave
San Bernardino, CA 92405-3839
Phone (909) 881-7320
Other practice location 2
1364 N Waterman Ave
San Bernardino, CA 92404-5313
Phone (909) 361-3061
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A1094320 | Medicaid | CA |
Other providers in San Bernardino, CA
- Sara Matthews
- Talia Mau
- Nancy Elizabeth Maurer
- Steven Dale Mauro
- Annie A Mavian
- Maxim Healthcare Services, Inc.
- Maxim Healthcare Services, Inc.
- Maxim Healthcare Services, Inc.
- Maxim Healthcare Services, Inc.
- Clare Louise Maxwell
All providers in San Bernardino, CA · Obstetrics & Gynecology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.