Ghada Othman Al-Asadi, MD
Individual provider Active NPI Psychiatry Physician · Glendora, CA
NPI 1598875239 · NPPES record last updated Nov 30, 2022
Key facts
- NPI
- 1598875239
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- C50587 (CA)
- Practice address
- 415 W Route 66
Ste 202
Glendora, CA 91740-4335 - Phone
- (626) 963-4467
- Fax
- (626) 963-9543
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 1975
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2705 S Diamond Bar Blvd
Suite 238
Diamond Bar, CA 91765-3554
Phone (909) 860-2166
415 W Route 66
Suite 202
Glendora, CA 91740-4335
Phone (626) 963-4467
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080121000064 | CA | Practitioner - Psychiatry |
2365530334 | Practice locations: Chino, CA; Diamond Bar, CA; Glendora, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C50587 | CA | MD | Psychiatry Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- ghada.alasadi.p5@direct.mydohc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | C50587 | CA | Yes |
Addresses
Primary practice location
415 W Route 66
Ste 202
Glendora, CA 91740-4335
Mailing address
415 W Route 66
Ste 202
Glendora, CA 91740-4335
Phone (626) 963-4467
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G3431 | Other | LA | BCBS |
| 1991660 | Medicaid | LA |
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All providers in Glendora, CA · Psychiatry Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.