Maryam A. Abdelnaby, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A80495 Issued in CA

Practice address

25825 Vermont Ave
Harbor City, CA 90710-3518

Phone

(310) 325-5111

NPI assigned

Jan 17, 2007

Last updated

Mar 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Medical College of Wisconsin, 2001

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Maryam a. Abdelnaby, M.D. Inc.

  dba West Coast Regional Medical Group

  • Internal Medicine Physician
  • Torrance, CA
  • NPI 1285835793
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1104978568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2563 PLAZA DEL AMO",
            "address_2": "UNIT 406",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905038958",
            "telephone_number": "310-991-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-325-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELNABY",
        "first_name": "MARYAM",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A80495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A804950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 247 Home Health Services
• Christiana Abraham, NP
• Kamren Ackerman
• Bradley K. Ackerson, MD
• Active Health Concepts
• Active Life Home Care Inc

• Family Medicine Physician in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.