NPIMap

Organization Active NPI

Samy Farag, M.D. Medical Group, MC

  • Multi-Specialty Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1245265750
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
A25821 Issued in CA
Legal business name
SAMY FARAG, M.D. MEDICAL GROUP, MC
Practice address
4430 Santa Monica Blvd
Suite 101
Los Angeles, CA 90029-2014
Phone
(323) 665-5600
Fax
(323) 665-8500
NPI assigned
Jul 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Samy S Farag, MDNPI 1518932474
Title
Owner
Phone
(323) 665-5600

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
Multi-Specialty Clinic/Center 261QM1300X A25821 CA Primary

Addresses

Primary practice location

4430 Santa Monica Blvd
Suite 101
Los Angeles, CA 90029-2014

Mailing address

PO Box 781
La Canada, CA 91012-0781
Phone (323) 665-5600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245265750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910120781",
            "telephone_number": "323-665-5600",
            "fax_number": "323-665-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 SANTA MONICA BLVD",
            "address_2": "SUITE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900292014",
            "telephone_number": "323-665-5600",
            "fax_number": "323-665-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMY FARAG, M.D. MEDICAL GROUP, MC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FARAG",
        "authorized_official_first_name": "SAMY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-665-5600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "A25821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.