Organization Active NPI

Maryam a. Abdelnaby, M.D. Inc.

  • Internal Medicine Physician
  • Torrance, CA
National Provider Identifier
1285835793
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A80495 Issued in CA
Legal business name
MARYAM A. ABDELNABY, M.D. INC.
Practice address
23700 Camino del Sol
Torrance, CA 90505-5017
Phone
(310) 991-6569
NPI assigned
May 31, 2007
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
Dr. Maryam Ahmed Abdelnaby, M.D.NPI 1104978568
Title
President
Phone
(310) 991-6569

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 A80495 CA Primary

Addresses

Primary practice location

23700 Camino del Sol
Torrance, CA 90505-5017

Mailing address

2563 Plaza del Amo Unit 406
Torrance, CA 90503-8958
Phone (310) 991-6569

Other names 1

  • West Coast Regional Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071228000167 CA Part B Supplier - Clinic/Group Practice 4486734746 Receives reassigned benefits from 1 practitioner
Practice locations: Costa Mesa, CA

National Provider Directory

National Provider Directory

Locations

301 Victoria St
Costa Mesa, CA 92627
Phone (949) 207-3457

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": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285835793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2563 PLAZA DEL AMO UNIT 406",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905038958",
            "telephone_number": "310-991-6569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23700 CAMINO DEL SOL",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905055017",
            "telephone_number": "310-991-6569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYAM A. ABDELNABY, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ABDELNABY",
        "authorized_official_first_name": "MARYAM",
        "authorized_official_middle_name": "AHMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-991-6569",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A80495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Coast Regional Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Torrance, 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.
  • 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.