Organization Active NPI

Sunshine Medical Clinic Inc

  • Internal Medicine Physician
  • Compton, CA
National Provider Identifier
1386721900
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66225 Issued in CA
Legal business name
SUNSHINE MEDICAL CLINIC INC
Practice address
555 W Compton Blvd Ste 104
Compton, CA 90220-3099
Phone
(310) 639-7200
Fax
(310) 639-0200
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Dr. Muhammad J Memon, M.D.NPI 1689744120
Title
Secretary
Phone
(310) 639-7200

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: 193200000X MULTI-SPECIALTY GROUP 207R00000X A66225 CA Primary

Addresses

Primary practice location

555 W Compton Blvd Ste 104
Compton, CA 90220-3099

Mailing address

555 W Compton Blvd Ste 104
Compton, CA 90220-3099
Phone (310) 639-7200

Other identifiers 3

IdentifierTypeStateIssuer
P00121487OtherCACHAMPUS ID
GR0089750MedicaidCA
ZZZ03316ZOtherCABLUE SHIELD ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120117000325 CA Part B Supplier - Clinic/Group Practice 6901073964 Receives reassigned benefits from 2 practitioners
Practice locations: Compton, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0893384Sunshine Medical Clinic Inc555 W Compton Suite 104, Compton, CA 90220Certificate of waiverAug 18, 2027

National Provider Directory

National Provider Directory

Locations

555 W Compton Blvd
Ste 104
Compton, CA 90220
Phone (310) 639-7200

Practitioners & affiliated clinicians

Practitioners 2

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1386721900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COMPTON BLVD STE 104",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203099",
            "telephone_number": "310-639-7200",
            "fax_number": "310-639-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COMPTON BLVD STE 104",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203099",
            "telephone_number": "310-639-7200",
            "fax_number": "310-639-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MEMON",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "310-639-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS ID",
            "identifier": "P00121487",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0089750",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID",
            "identifier": "ZZZ03316Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.