Odette R Tawadrous Medical Clinic Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ODETTE R TAWADROUS MEDICAL CLINIC INC.

Practice address

3625 Martin Luther King Jr Blvd Ste 10
Lynwood, CA 90262-3509

Phone

(310) 223-1429

Fax

(310) 223-1432

NPI assigned

May 12, 2016

Last updated

May 12, 2016By 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

Dr. Odette R Tawadrous, M.D.NPI 1669661492

Title

President

Phone

(310) 223-1429

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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.

• Odette R Tawadrous, MD

  • Internal Medicine Physician
  • Lynwood, CA
  • NPI 1669661492
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463011200000",
    "number": "1558717165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1018",
            "city": "ARTESIA",
            "state": "CA",
            "postal_code": "907021018",
            "telephone_number": "310-223-1429",
            "fax_number": "310-223-1432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MARTIN LUTHER KING JR BLVD STE 10",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623509",
            "telephone_number": "310-223-1429",
            "fax_number": "310-223-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODETTE R TAWADROUS MEDICAL CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A",
        "authorized_official_last_name": "TAWADROUS",
        "authorized_official_first_name": "ODETTE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-223-1429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly O'Brien, LCSW
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• Yvonne Ochoa
• Bosco Omezy Ofoegbu
• Anthony Ogundipe
• Ola Ethel Ojeikere
• Blessing Chioma Okafor, NP-C
• Theodore B Okie

• Internal Medicine Physician in Lynwood, CA
• Providers in Lynwood, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.