Socal Healthnet Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

GR008540 Issued in CA

Legal business name

SOCAL HEALTHNET INC

Doing business as

St. Luke Medical Clinic

Practice address

5912 Santa Monica Blvd
Los Angeles, CA 90038-2043

Phone

(323) 461-3888

Fax

(323) 461-3250

NPI assigned

Feb 9, 2008

Last updated

Mar 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nabil F Khalil, M.D.NPI 1649387879

Title

Medical Director

Phone

(323) 461-3888

Specialties & licenses 1

Addresses

Other names 1

• St. Luke Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicholas Andrew Rogers, MD

  • Obstetrics & Gynecology Physician
  • Palmdale, CA
  • NPI 1124203583
  Medicare reassignment Care Compare group NPD
• Glenn Edward Miller, M.D.

  • Obstetrics & Gynecology Physician
  • Santa Monica, CA
  • NPI 1902108764
  Medicare reassignment Care Compare group
• Nicola Faris Azar, M.D.

  • Family Medicine Physician
  • Thousand Oaks, CA
  • NPI 1922259787
  Medicare reassignment NPD
• Paula Bailey-Walton, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1174646590
  Medicare reassignment NPD
• Ira Kenneth Grove, M.D.

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1659327112
  Medicare reassignment NPD
• Amir H Rad, M.D

  • Nuclear Medicine Physician
  • San Diego, CA
  • NPI 1710262472
  Medicare reassignment NPD
• Johnny-an Thanh Pham, PA C

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1457332504
  Medicare reassignment
• Nabil F Khalil, MD

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1649387879
  Authorized official Same address or phone

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

{
    "created_epoch": "1202515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269216000000",
    "number": "1487832655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5912 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900382043",
            "telephone_number": "323-461-3888",
            "fax_number": "323-461-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5912 SANTA MONICA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900382043",
            "telephone_number": "323-461-3888",
            "fax_number": "323-461-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL HEALTHNET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-09",
        "last_updated": "2010-03-22",
        "status": "A",
        "authorized_official_last_name": "KHALIL",
        "authorized_official_first_name": "NABIL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "323-461-3888",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CA",
            "license": "GR008540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Luke Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Claudia Sobral
• Socal Anesthesia Solutions Inc
• Socal Anesthesia Solutions, Inc
• Socal Behavioral Health Solutions LLC
• Socal Flu Shots
• Socal Imaging
• Socal Interpriting
• Socal Medical Group
• Socal Psychiatric Medical Group, a Medical Corporation (Industrial Psychiatric Network)
• Socal Recuperative Care

• Multi-Specialty Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Multi-Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2010; 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.