Socal Healthnet Inc

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

GR008540 Issued in CA

Legal business name

SOCAL HEALTHNET INC

Practice address

5912 Santa Monica Blvd
Los Angeles, CA 90038-2043

Phone

(323) 461-3888

Fax

(323) 461-3250

NPI assigned

Feb 9, 2008

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.

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

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• 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

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
• 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.