Individual provider Active NPI

Nabil Nazir Soliman, M.D.

  • Family Medicine Physician
  • Hawthorne, CA
National Provider Identifier
1831114289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A40595 Issued in CA
Practice address
11946 Hawthorne Blvd
Hawthorne, CA 90250-3016
Phone
(310) 675-1136
Fax
(310) 970-1447
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A40595 CA Primary

Addresses

Primary practice location

11946 Hawthorne Blvd
Hawthorne, CA 90250-3016

Mailing address

1121 Roberto LN
Los Angeles, CA 90077-2302
Phone (310) 471-1254

Other identifiers 1

IdentifierTypeStateIssuer
GR0057390MedicaidCA

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
I20101108000625 CA Practitioner - General Practice 6901091685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centro Medico IncGroup PAC ID 2163617846, 3 clinicians

Practice addresses (Care Compare)

11946 Hawthorne Blvd
Hawthorne, CA 90250-3016
Phone (310) 675-1136

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A40595CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico Inc. Family Medicine CurrentSince Jun 1, 1993 Accepting new patients

Locations

11946 Hawthorne Blvd
Hawthorne, CA 90250
Phone (310) 675-1136

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831114289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 ROBERTO LN",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900772302",
            "telephone_number": "310-471-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11946 HAWTHORNE BLVD",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503016",
            "telephone_number": "310-675-1136",
            "fax_number": "310-970-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIMAN",
        "first_name": "NABIL",
        "middle_name": "NAZIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A40595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0057390",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.