Individual provider Active NPI

Marc Ghabbour, M.D.

  • Internal Medicine Physician
  • Glendora, CA
National Provider Identifier
1154702157
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
081035 Issued in GA
Practice address
552 W Foothill Blvd Ste 100
Glendora, CA 91741-2470
Phone
(626) 335-4079
NPI assigned
Jun 16, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN21395 FL
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 081035 GA Primary

Addresses

Primary practice location

552 W Foothill Blvd Ste 100
Glendora, CA 91741-2470

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Other practice location 1

455 Philip Blvd Ste 130
Lawrenceville, GA 30046
Phone (800) 611-1811

Other practice location 2

670 Glades Rd Ste 400
Boca Raton, FL 33431-6464
Phone (561) 955-2570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181108002952 GA Practitioner - Internal Medicine 2264723949 Reassigns benefits to 1 organization
I20220106002347 CA Practitioner - Internal Medicine 2264723949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1236 N Magnolia Ave
Anaheim, CA 92801-2607
Phone (714) 995-1000

2025 E Route 66
Glendora, CA 91740-4670
Phone (626) 335-4610

552 W Foothill Blvd
Suite 100
Glendora, CA 91741-2470
Phone (626) 335-4079

824 E Carson St
Suite 104
Carson, CA 90745-2262
Phone (310) 830-9706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TRN21395FLMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Multi-Specialty CurrentSince Dec 6, 2021 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Dec 6, 2021 Accepting new patients
The Southeast Permanente Medical Group Multi-Specialty CurrentSince Aug 27, 2018 Accepting new patients
Memorial Medical Group Inc Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

5957 W Ramsey St
Banning, CA 92220
Phone (951) 845-8864

2910 Jefferson St
Ste 100
Carlsbad, CA 92008
Phone (760) 729-8600

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

552 W Foothill Blvd
Ste 100
Glendora, CA 91741
Phone (626) 335-4079

1700 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 883-8611

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

455 Philip Blvd
Ste 130
Lawrenceville, GA 30046
Phone (678) 985-5000

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mghabbour206918@westdirect.optum.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1154702157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 W FOOTHILL BLVD STE 100",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917412470",
            "telephone_number": "626-335-4079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Philip Blvd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "30046",
            "country_code": "US",
            "telephone_number": "800-611-1811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "670 Glades Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334316464",
            "country_code": "US",
            "telephone_number": "561-955-2570",
            "fax_number": "561-955-2572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHABBOUR",
        "first_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN21395",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "081035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.