Mary Gamil Absood, M.D.

Individual provider Active NPI Internal Medicine Physician · Covina, CA

NPI 1497735906 · NPPES record last updated Jun 5, 2013

Key facts

NPI
1497735906
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
A73772 (CA)
Practice address
420 W Rowland St
Covina, CA 91723-2943
Phone
(626) 331-6411
Fax
(626) 251-1560
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Internal Medicine
Also: Pediatric Medicine
Education
Meharry Medical College School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Department of State Hospitals (275 clinicians)

Practice addresses (Care Compare)

11401 Bloomfield Ave
Norwalk, CA 90650-2015
Phone (916) 651-8811

Hospital & facility affiliations

  • Los Angeles Community Hospital Hospital · Los Angeles, CA · CCN 050663
  • Coast Plaza Hospital Hospital · Norwalk, CA · CCN 050771

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040907000766 CA Practitioner - Internal Medicine
Practitioner - Pediatric Medicine
7012983521 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current
since Dec 1, 2014
Accepting new patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals Current
since Dec 1, 2014
Accepting new patients
Jse Emergency Medical Group Past Accepting new patients

Locations

11401 Bloomfield Ave
Norwalk, CA 90650
Phone (562) 863-7011

1600 9th St
Ste 150
Sacramento, CA 95814
Phone (916) 651-8811

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A73772 CA Yes
Pediatrics Physician 208000000X A73772 CA

Addresses

Primary practice location

420 W Rowland St
Covina, CA 91723-2943

Mailing address

420 W Rowland St
Covina, CA 91723-2943
Phone (626) 331-6411

Other providers in Covina, CA

All providers in Covina, CA · Internal Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.