Individual provider Active NPI

Adel A Salam, RPT BS PHYSICAL THER

  • Physical Therapist
  • Lakewood, CA
National Provider Identifier
1124191168
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8627 Issued in CA
Practice address
5750 Downey Ave
#301
Lakewood, CA 90712
Phone
(562) 633-3501
Fax
(562) 633-6178
NPI assigned
Nov 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT8627 CA Primary

Addresses

Primary practice location

5750 Downey Ave
#301
Lakewood, CA 90712

Mailing address

5750 Downey Ave
#301
Lakewood, CA 90712
Phone (562) 633-3501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111122000424 CA Practitioner - Physical Therapist in Private Practice 2860666195 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5750 Downey Ave
Suite 301
Lakewood, CA 90712-1469
Phone (562) 633-3501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
PT8627CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Physical Therapy Physical Therapist CurrentSince Jan 12, 2001 Accepting new patients
Long Beach - Lakewood Orthopedic Institute Physical Therapist Past Accepting new patients

Locations

17752 Beach Blvd
Ste 306
Huntington Beach, CA 92647
Phone (714) 842-6171

5750 Downey Ave
Ste 301
Lakewood, CA 90712
Phone (562) 633-3501

5220 Clark Ave
Ste 205
Lakewood, CA 90712
Phone (562) 421-1008

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124191168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750 DOWNEY AVE",
            "address_2": "#301",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "90712",
            "telephone_number": "562-633-3501",
            "fax_number": "562-633-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 DOWNEY AVE",
            "address_2": "#301",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "90712",
            "telephone_number": "562-633-3501",
            "fax_number": "562-633-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAM",
        "first_name": "ADEL",
        "middle_name": "A",
        "credential": "RPT BS PHYSICAL THER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT8627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.