Active NPI
Mohamed A Elbaz, MS MB(ASCP)
- Laboratory Management Specialist/Technologist
- Templeton, CA
National Provider Identifier
1295079242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Laboratory Management Specialist/Technologist
- Practice address
- 1050 Las Tablas Rd Ste 14
Templeton, CA 93465-9480 - Phone
- (503) 464-6467
- NPI assigned
- Nov 15, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Technologist | 246QM0706X | 1825 | OR | |
| Biochemist | 246ZB0500X | |||
| Laboratory Management Specialist/Technologist | 246QL0900X | TX | Primary |
Addresses
Primary practice location
1050 Las Tablas Rd Ste 14
Templeton, CA 93465-9480
Mailing address
5351 S Vincent
Mesa, AZ 85212-9113
Phone (503) 464-6467
Other practice location 1
5130 Gateway Blvd E
El Paso, TX 79905-1608
Phone (503) 464-6467
Other practice location 2
13705 NE Airport Way
Portland, OR 97230-1048
Phone (503) 464-6467
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1825 | OR | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1295079242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5351 S VINCENT",
"city": "MESA",
"state": "AZ",
"postal_code": "852129113",
"telephone_number": "503-464-6467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 LAS TABLAS RD STE 14",
"city": "TEMPLETON",
"state": "CA",
"postal_code": "934659480",
"telephone_number": "503-464-6467"
}
],
"practiceLocations": [
{
"address_1": "5130 Gateway Blvd E",
"address_purpose": "LOCATION",
"city": "El Paso",
"state": "TX",
"postal_code": "799051608",
"country_code": "US",
"telephone_number": "503-464-6467",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "13705 NE Airport Way",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972301048",
"country_code": "US",
"telephone_number": "503-464-6467",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELBAZ",
"first_name": "MOHAMED",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "MS MB(ASCP)",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-15",
"last_updated": "2021-01-14",
"certification_date": "2021-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "246QM0706X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Medical Technologist",
"state": "OR",
"license": "1825",
"primary": false
},
{
"code": "246ZB0500X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Biochemist",
"state": null,
"license": null,
"primary": false
},
{
"code": "246QL0900X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Laboratory Management",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Templeton, CA
- Byron Patrick Dubow, M.D.
- Michele Duero
- Ear Nose and Throat Medical Clinic Inc
- Raul Benjamin Easton-Carr, M.D.
- Jennifer Eckerman, P.A.
- Elise Tobin Ms Marriage and Family Therapy Inc
- Elizabeth C. Beal, D.O., a Professional Medical Corporation
- Gregg Alan Ellison, MD
- Christine Emory Jacobson
- Justin R Evans, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.