Eaman Balouch, MD PHD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A167007 Issued in CA

Practice address

222 N Pacific Coast Hwy Ste 1420
El Segundo, CA 90245-5648

Phone

(310) 524-1305

NPI assigned

Jul 12, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

General Practice

Education

University of California, Davis School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Robert Marriott Medical CorpGroup PAC ID 2567531494, 63 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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 and National Provider Directory roles.

• Robert Marriott Medical Corp

  • Surgery Physician
  • El Segundo, CA
  • NPI 1083883938

  Multi-Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1265884498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 1420",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455648",
            "telephone_number": "310-524-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N PACIFIC COAST HWY STE 1420",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902455648",
            "telephone_number": "310-524-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5670 Elvas Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958193309",
            "country_code": "US",
            "telephone_number": "310-498-3779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALOUCH",
        "first_name": "EAMAN",
        "credential": "MD PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-12",
        "last_updated": "2023-03-07",
        "certification_date": "2021-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A167007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava Balfour
• Matthew Scott Ball, DPT
• Svetlana Ballard
• Alejandra Ballestero
• Marlene Ballon
• Isabella Balvaneda
• Niketh Bandla, M.D.
• Meshell Bane
• Katie Banh
• Shajade Bank

• General Practice Physician in El Segundo, CA
• Providers in El Segundo, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.