California Pulmonary Disease Medical Group Inc

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

Legal business name

CALIFORNIA PULMONARY DISEASE MEDICAL GROUP INC

Practice address

1200 Shadow Hill Way
Beverly Hills, CA 90210

Phone

(310) 821-1187

Fax

(310) 276-7289

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Fouad E Ben-Isaac, MD

Title

Owner Medical Doctor

Phone

(310) 821-1187

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Fouad Ben Isaac MD Former legal business name

Locations

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1063560902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SHADOW HILL WAY",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "310-821-1187",
            "fax_number": "310-276-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SHADOW HILL WAY",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "90210",
            "telephone_number": "310-821-1187",
            "fax_number": "310-276-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA PULMONARY DISEASE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "BEN-ISAAC",
        "authorized_official_first_name": "FOUAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER MEDICAL DOCTOR",
        "authorized_official_telephone_number": "310-821-1187",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A252520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fouad Ben Isaac MD",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.