NPIMap

Organization Active NPI

Feras and Hisham a Medical Corporation

Doing business as Family First Medical Clinic

  • Health Service Clinic/Center
  • Pomona, CA
National Provider Identifier
1700055274
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
FERAS AND HISHAM A MEDICAL CORPORATION
Doing business as
Family First Medical Clinic
Practice address
2112 S Garey Ave
Suite C
Pomona, CA 91766-5600
Phone
(909) 464-0520
Fax
(909) 464-0523
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Mosen M Defrawy, MDNPI 1457409401
Title
Owner/Medical Director
Phone
(909) 464-0520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X A30899 CA
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

2112 S Garey Ave
Suite C
Pomona, CA 91766-5600

Mailing address

2112 S Garey Ave
Suite C
Pomona, CA 91766-5600
Phone (909) 464-0520

Other identifiers 1

IdentifierTypeStateIssuer
1083747612MedicaidCA

Other names 1

  • FAMILY FIRST MEDICAL CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050901000231 CA Part B Supplier - Clinic/Group Practice 4082646815 Receives reassigned benefits from 1 practitioner
Practice locations: Pomona, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1700055274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 S GAREY AVE",
            "address_2": "SUITE C",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665600",
            "telephone_number": "909-464-0520",
            "fax_number": "909-464-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 S GAREY AVE",
            "address_2": "SUITE C",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665600",
            "telephone_number": "909-464-0520",
            "fax_number": "909-464-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERAS AND HISHAM A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "DEFRAWY",
        "authorized_official_first_name": "MOSEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "909-464-0520",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A30899",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083747612",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY FIRST MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.