NPIMap

Organization Active NPI

Cardio Medical Consultants Group of Long Beach Inc

  • Cardiovascular Disease Physician
  • Lynwood, CA
National Provider Identifier
1821135617
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CARDIO MEDICAL CONSULTANTS GROUP OF LONG BEACH INC
Practice address
3737 Martin Luther King Jr Blvd
# 401
Lynwood, CA 90262-3513
Phone
(310) 604-0443
Fax
(310) 604-3367
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Dr. Amin Farah, M.D.NPI 1902908080
Title
President
Phone
(310) 604-0443

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

3737 Martin Luther King Jr Blvd
# 401
Lynwood, CA 90262-3513

Mailing address

3737 Martin Luther King Jr Blvd
# 401
Lynwood, CA 90262-3513
Phone (310) 604-0443

Other identifiers 4

IdentifierTypeStateIssuer
1891898797OtherCANPI
1700100906OtherCANPI
1376693325OtherCANPI
1902908080OtherCANPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080407000167 CA Part B Supplier - Clinic/Group Practice 7416034061 Receives reassigned benefits from 7 practitioners
Practice locations: Lynwood, CA; Downey, CA

National Provider Directory

National Provider Directory

Locations

8327 Davis St
Ste 101
Downey, CA 90241
Phone (213) 604-0443

3621 Martin Luther King Jr Blvd
Ste 15
Lynwood, CA 90262
Phone (213) 604-0443

Practitioners & affiliated clinicians

Practitioners 10

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": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1821135617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "# 401",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "310-604-0443",
            "fax_number": "310-604-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 MARTIN LUTHER KING JR BLVD",
            "address_2": "# 401",
            "city": "LYNWOOD",
            "state": "CA",
            "postal_code": "902623513",
            "telephone_number": "310-604-0443",
            "fax_number": "310-604-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIO MEDICAL CONSULTANTS GROUP OF LONG BEACH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "FARAH",
        "authorized_official_first_name": "AMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-604-0443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1891898797",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1700100906",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376693325",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1902908080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.