Individual provider Active NPI

Maianh Dam

  • Geriatric Medicine (Family Medicine) Physician
  • Loma Linda, CA
National Provider Identifier
1285194142
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
A181397 Issued in CA
Practice address
25455 Barton Rd Ste 204B
Loma Linda, CA 92354-3130
Phone
(909) 558-6600
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X A181397 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

25455 Barton Rd Ste 204B
Loma Linda, CA 92354-3130

Mailing address

File # 54701
Los Angeles, CA 90074-4701
Phone (909) 651-4300

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
I20231005002031 CA Practitioner - Family Practice 4981059268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11370 Anderson St
Loma Linda, CA 92354-3450

25455 Barton Rd
Suite 108a
Loma Linda, CA 92354-3139
Phone (909) 558-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A181397CAMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Sep 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients

Locations

81 Highland Springs Ave
Ste 103
Beaumont, CA 92223
Phone (909) 558-2830

11234 Anderson St
#A600
Loma Linda, CA 92350
Phone (909) 558-2824

25455 Barton Rd
#215A
Loma Linda, CA 92354

25455 Barton Rd
Ste 204B
Loma Linda, CA 92354
Phone (909) 558-6526

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File 54701
Los Angeles, CA 90074
Phone (909) 651-4300

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

Interoperability endpoints

  • Direct secure messaging: mdam852291@direct.llu.edu

Organizations & group practices 9

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1285194142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FILE # 54701",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-651-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25455 BARTON RD STE 204B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543130",
            "telephone_number": "909-558-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAM",
        "first_name": "MAIANH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A181397",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.