Organization Active NPI

Autumn Medical Group

  • Family Medicine Physician
  • Whittier, CA
National Provider Identifier
1881746022
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A84718 Issued in CA
Legal business name
AUTUMN MEDICAL GROUP
Practice address
9200 Colima Rd
Suite 207
Whittier, CA 90605-1814
Phone
(562) 945-0252
Fax
(562) 945-0901
NPI assigned
Jan 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Authorized official

Name
Dr. Nasir A Mohammedi, M.D.,M.S.,M.S.,NPI 1154429769
Title
Ceo
Phone
(562) 945-0252

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A84718 CA Primary

Addresses

Primary practice location

9200 Colima Rd
Suite 207
Whittier, CA 90605-1814

Mailing address

9200 Colima Rd
Suite 207
Whittier, CA 90605-1814
Phone (562) 945-0252

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081111000300 CA Part B Supplier - Clinic/Group Practice 4183783707 Receives reassigned benefits from 1 practitioner
Practice locations: Whittier, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1084831Autumn Medical Group9200 Colima Rd Suite 207, Whittier, CA 90605Certificate of waiverMay 14, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

9200 Colima Rd
Ste 207
Whittier, CA 90605
Phone (562) 945-0252

Practitioners & affiliated clinicians

Practitioners 1

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": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1881746022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 COLIMA RD",
            "address_2": "SUITE 207",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051814",
            "telephone_number": "562-945-0252",
            "fax_number": "562-945-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 COLIMA RD",
            "address_2": "SUITE 207",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051814",
            "telephone_number": "562-945-0252",
            "fax_number": "562-945-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTUMN MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "MOHAMMEDI",
        "authorized_official_first_name": "NASIR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "562-945-0252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D.,M.S.,M.S.,"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A84718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.