Organization Active NPI

Dagher MD Medical Group Inc

  • Internal Medicine Physician
  • Covina, CA
National Provider Identifier
1194037879
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A98565 Issued in CA
Legal business name
DAGHER MD MEDICAL GROUP INC
Practice address
376 W Badillo St
Covina, CA 91723-1827
Phone
(626) 332-1175
Fax
(626) 966-8746
NPI assigned
Jul 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Nadim Dagher, MDNPI 1053531467
Title
Owner
Phone
(626) 332-1175

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A98565 CA Primary

Addresses

Primary practice location

376 W Badillo St
Covina, CA 91723-1827

Mailing address

376 W Badillo St
Covina, CA 91723-1827
Phone (626) 332-1175

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100712000412 CA Part B Supplier - Clinic/Group Practice 6103958087 Receives reassigned benefits from 1 practitioner
Practice locations: Covina, CA

National Provider Directory

National Provider Directory
Tax ID family
Dagher MD Medical Group Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

530 W Badillo St
#D
Covina, CA 91722
Phone (626) 332-1175

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1194037879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231827",
            "telephone_number": "626-332-1175",
            "fax_number": "626-966-8746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "376 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231827",
            "telephone_number": "626-332-1175",
            "fax_number": "626-966-8746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAGHER MD MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "DAGHER",
        "authorized_official_first_name": "NADIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-332-1175",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A98565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.