Individual provider Active NPI

Husam A Abdulnour, M.D

  • Pediatrics Physician
  • Modesto, CA
National Provider Identifier
1740451749
Registry record updated Apr 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A1114666 Issued in CA
Practice address
1441 Florida Ave
Modesto, CA 95350-4404
Phone
(209) 558-7248
Fax
(209) 558-8723
NPI assigned
Mar 18, 2008
Last updated
Apr 5, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125-049961 IL
Pediatrics Physician 208000000X A1114666 CA Primary

Addresses

Primary practice location

1441 Florida Ave
Modesto, CA 95350-4404

Mailing address

737 W Childs Ave
Merced, CA 95341-6805
Phone (209) 384-6493

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110808000691 CA Practitioner - Pediatric MedicinePractitioner - Nephrology 2466621438 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A1114666CAMDPediatrics Physician
125-049961ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden Valley Health Centers CurrentSince Dec 6, 2024 Accepting new patients
Golden Valley Health Center CurrentSince Dec 6, 2024 Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Centers Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Golden Valley Health Center Current Accepting new patients
Scenic Faculty Medical Group, Inc. PastSince Sep 1, 2024 Accepting new patients

Locations

1910 Customer Care Way
Atwater, CA 95301
Phone (209) 384-6488

1405 California Ave
Dos Palos, CA 93620
Phone (209) 392-2111

13161 Jefferson St
Le Grand, CA 95333
Phone (209) 389-1900

821 Texas Ave
Los Banos, CA 93635
Phone (209) 385-5481

250 Northgate Dr
Manteca, CA 95336
Phone (209) 381-7120

3940 Sandpiper Ave
Merced, CA 95340
Phone (209) 381-4104

737 W Childs Ave
Merced, CA 95341
Phone (209) 383-1848

797 W Childs Ave
Merced, CA 95341
Phone (209) 383-5871

847 W Childs Ave
Merced, CA 95341
Phone (209) 383-7441

1114 6th St
Modesto, CA 95354
Phone (209) 576-2845

1121 Hammond St
Modesto, CA 95351
Phone (209) 384-6488

1500 Florida Ave
Modesto, CA 95350
Phone (209) 571-5071

1717 Las Vegas St
Modesto, CA 95358
Phone (209) 576-4200

2101 Tenaya Dr
Modesto, CA 95354
Phone (209) 527-0080

637 Merced St
Newman, CA 95360
Phone (209) 862-0270

200 C St
Patterson, CA 95363
Phone (209) 892-6307

9235 E Broadway St
Planada, CA 95365
Phone (209) 382-0253

4150 Patterson Rd
Riverbank, CA 95367
Phone (209) 628-4435

1200 W Main St
Turlock, CA 95380
Phone (209) 668-5388

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491350400000",
    "number": "1740451749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 W CHILDS AVE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953416805",
            "telephone_number": "209-384-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-558-7248",
            "fax_number": "209-558-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDULNOUR",
        "first_name": "HUSAM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-18",
        "last_updated": "2017-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125-049961",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A1114666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.