NPIMap

Individual provider Active NPI

Muhammad J Memon, M.D.

  • Internal Medicine Physician
  • Compton, CA
National Provider Identifier
1689744120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66225 Issued in CA
Practice address
555 W Compton Blvd Ste 104
Compton, CA 90220-3099
Phone
(310) 639-7200
Fax
(310) 639-0200
NPI assigned
Nov 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A66225 CA Primary

Addresses

Primary practice location

555 W Compton Blvd Ste 104
Compton, CA 90220-3099

Mailing address

555 W Compton Blvd Ste 104
Compton, CA 90220-3099
Phone (310) 639-7200

Other identifiers 6

IdentifierTypeStateIssuer
54220ZZZ03316ZOtherCABLUE SHIELD ID
05D0893384OtherCACLIA #
207Q00000XOtherCATAXED ID
00A662250MedicaidCA
DB6816OtherCAUNIQ SUPPL ID
A66225OtherCAMEDICAL LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100215000403 CA Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 6305980335 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
Other, 1988
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Sunshine Medical Clinic IncGroup PAC ID 6901073964, 2 clinicians

Practice addresses (Care Compare)

555 W Compton Blvd
Compton, CA 90220-3099
Phone (310) 639-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A66225CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Medical Clinic Inc Internal Medicine CurrentSince Dec 14, 2016 Accepting new patients
Innovative Medical Solutions Inc a Medical Group Internal Medicine CurrentSince Sep 1, 2020 Accepting new patients

Locations

8920 Wilshire Blvd
Ste 310
Beverly Hills, CA 90211
Phone (310) 256-2426

555 W Compton Blvd
Ste 104
Compton, CA 90220
Phone (310) 639-7200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689744120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COMPTON BLVD STE 104",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203099",
            "telephone_number": "310-639-7200",
            "fax_number": "310-639-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COMPTON BLVD STE 104",
            "city": "COMPTON",
            "state": "CA",
            "postal_code": "902203099",
            "telephone_number": "310-639-7200",
            "fax_number": "310-639-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMON",
        "first_name": "MUHAMMAD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID",
            "identifier": "54220ZZZ03316Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "05D0893384",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXED ID",
            "identifier": "207Q00000X",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A662250",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIQ SUPPL ID",
            "identifier": "DB6816",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LIC",
            "identifier": "A66225",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Compton, CA

Sources for this page

Verify at the official NPI Registry.