Glendale Doctors Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

A41065 Issued in CA

Legal business name

GLENDALE DOCTORS MEDICAL CENTER

Doing business as

Panorama Doctors Medical Center

Practice address

1123 S. Central Ave
Glendale, CA 91204-2212

Phone

(818) 242-8805

Fax

(818) 242-4442

NPI assigned

Jan 19, 2012

Last updated

Jun 28, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

DOCTORS HEALTH MEDICAL CENTERS INCAs reported in NPPES

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

Authorized official

Name

Mr. Tahsin Ali Waheb, MDNPI 1427396738

Title

Ceo

Phone

(818) 242-8805

Specialties & licenses 4

Addresses

Other names 1

• Panorama Doctors Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Part of

Glendale Doctors Medical Center

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Louis B Flores, M.D.

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1760606123
  Medicare reassignment
• Tahsin Ali Waheb, M.D.

  • Surgery Physician
  • Glendale, CA
  • NPI 1427396738
  Authorized official Same address or phone
• Babak Mirabadi, DC

  • Chiropractor
  • Reseda, CA
  • NPI 1295379329
  NPD (past)

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467072000000",
    "number": "1801167044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 S. CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042212",
            "telephone_number": "818-242-8805",
            "fax_number": "818-242-4442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 S. CENTRAL AVE",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912042212",
            "telephone_number": "818-242-8805",
            "fax_number": "818-242-4442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENDALE DOCTORS MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DOCTORS HEALTH MEDICAL CENTERS INC",
        "enumeration_date": "2012-01-19",
        "last_updated": "2016-06-28",
        "status": "A",
        "authorized_official_last_name": "WAHEB",
        "authorized_official_first_name": "TAHSIN",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-242-8805",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "9962",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A32929",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A41065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Panorama Doctors Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Glendale, CA
• Providers in Glendale, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2016; 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.