Individual provider Active NPI

Ammar Matloob, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Corona, CA
National Provider Identifier
1780051565
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A172794 Issued in CA
Practice address
800 S Main St
Corona, CA 92882-3420
Phone
(951) 937-4343
NPI assigned
Aug 27, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A172794 CA Primary

Addresses

Primary practice location

800 S Main St
Corona, CA 92882-3420

Mailing address

PO Box 104231
Pasadena, CA 91189-4231
Phone (951) 437-4343

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
I20240911004816 CA Practitioner - Pathology 2062758147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boris Shlopov MD Pathology Medical CorporationGroup PAC ID 5890045306, 4 clinicians

Practice addresses (Care Compare)

800 S Main St
Corona, CA 92882-3420
Phone (951) 436-6383

Hospital & facility affiliations

  • Southwest Healthcare Rancho Springs Hospital Hospital, Murrieta, CA, CCN 050701
  • Corona Regional Medical Center Hospital, Corona, CA, CCN 050329
  • Temecula Valley Hospital Hospital, Temecula, CA, CCN 050775

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A172794CAMDAnatomic Pathology & Clinical Pathology Physician

Organizations & group practices 1

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

Hospital & facility affiliations 3

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1780051565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104231",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911894231",
            "telephone_number": "951-437-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823420",
            "telephone_number": "951-937-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATLOOB",
        "first_name": "AMMAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A172794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.