Individual provider Active NPI

Mohamad Raad, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1174804389
Registry record updated Aug 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A117840 Issued in CA
Practice address
1200 N State St
Los Angeles, CA 90033-1029
Phone
(323) 226-2601
NPI assigned
Sep 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A117840 CA
Internal Medicine Physician 207R00000X A117840 CA Primary

Addresses

Primary practice location

1200 N State St
Los Angeles, CA 90033-1029

Mailing address

2010 Zonal Ave
Opd 3P40A
Los Angeles, CA 90033-1026
Phone (323) 409-3233

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20211021002455 CA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7517355605

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A117840CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629417600000",
    "number": "1174804389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ZONAL AVE",
            "address_2": "OPD 3P40A",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331026",
            "telephone_number": "323-409-3233",
            "fax_number": "323-226-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAD",
        "first_name": "MOHAMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-01",
        "last_updated": "2021-08-20",
        "certification_date": "2021-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A117840",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A117840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.