Agustin Maria Abdallah, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

141310 Issued in CA

Practice address

245 S Fetterly Ave
Los Angeles, CA 90022-1605

Phone

(323) 362-1010

NPI assigned

Nov 1, 2014

Last updated

Nov 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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

Pediatric MedicineAlso: Internal Medicine

Education

Tulane University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of Los AngelesGroup PAC ID 1850296534, 395 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ogada Home Health Care, Inc Home health agency, Monterey Park, CA, CCN 559297
• Los Angeles General Medical Center Hospital, Los Angeles, CA, CCN 050373
• Lac/Rancho Los Amigos National Rehabilitation Ctr Hospital, Downey, CA, CCN 050717

Procedures performed for Medicare patients

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.

• County of Los Angeles

  dba County of Los Angeles Harbor UCLA Medical Center

  • General Acute Care Hospital
  • Torrance, CA
  • NPI 1851363188
  Medicare reassignment Care Compare group NPD
• County of Los Angeles

  dba Edward R. Roybal CHC

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1225048234
  NPD
• County of Los Angeles

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1295407401
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• County of Los Angeles

  dba LAC Rancho Los Amigos National Rehabilitation Center

  • General Acute Care Hospital
  • Downey, CA
  • NPI 1336154020
  Care Compare affiliation
• County of Los Angeles

  dba Los Angeles General Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1598773715
  Care Compare affiliation
• Ogada Home Health Care, Inc

  • Home Health Agency
  • Monterey Park, CA
  • NPI 1881239382
  Care Compare affiliation

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

{
    "created_epoch": "1414800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1134524184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "CT-A7D",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-7556",
            "fax_number": "323-226-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S FETTERLY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900221605",
            "telephone_number": "323-362-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDALLAH",
        "first_name": "AGUSTIN",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-01",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "141310",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "141310",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AA3232267556",
            "identifier": "AA3232267556",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gilbert Abdalian, LMFT
• Basmah Adel Abdalla, M.D.
• Iman Abdalla, MD
• Nuha Abdalla, PHARM D
• Wendy Sue Abdalla, CTRS
• Eman Abdallah, D.O.
• Sara Mohammad Abdallah, PA-C
• Yacoub Abdallah, DPT
• Hisham Mohamed Abdel-Azim, MD
• Danna Salam Abdel-Khader, MD

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.