Clinica Familiar San Lucas

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A36908 Issued in CA

Legal business name

CLINICA FAMILIAR SAN LUCAS

Practice address

11050 S Atlantic Ave
Lynwood, CA 90262-3068

Phone

(310) 635-3800

Fax

(310) 635-0364

NPI assigned

Oct 16, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Basil Felahy, MDNPI 1245389238

Title

President

Phone

(310) 635-3800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Basil Felahy, MD

  • Family Medicine Physician
  • Lynwood, CA
  • NPI 1245389238
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615852800000",
    "number": "1043462443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E GLENOAKS BLVD",
            "address_2": "SUITE 130",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912072085",
            "telephone_number": "818-549-1713",
            "fax_number": "818-549-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 S ATLANTIC AVE",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623068",
            "telephone_number": "310-635-3800",
            "fax_number": "310-635-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA FAMILIAR SAN LUCAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A",
        "authorized_official_last_name": "FELAHY",
        "authorized_official_first_name": "BASIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-635-3800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A36908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.