San Mateo Medical Clinic, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A35390 Issued in CA

Legal business name

SAN MATEO MEDICAL CLINIC, INC

Practice address

4055 Whittier Blvd
Los Angeles, CA 90023-2536

Phone

(323) 780-4000

Fax

(323) 780-9893

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Masad Arbid, M.D.NPI 1043366305

Title

Owner

Phone

(323) 780-4000

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Masad Isa Arbid, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1043366305
  Medicare reassignment NPD Authorized official
• Usama Salameh Khoury, PA-C

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1538227681
  NPD (past)
• Benigno Reyes Reyes Jr., MD

  • Obstetrics & Gynecology Physician
  • Los Angeles, CA
  • NPI 1144395559
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1881795003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5025",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912211025",
            "telephone_number": "323-780-4000",
            "fax_number": "323-780-9893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232536",
            "telephone_number": "323-780-4000",
            "fax_number": "323-780-9893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MATEO MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "ARBID",
        "authorized_official_first_name": "MASAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-780-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A35390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER LICENSE NUMBER",
            "identifier": "A35390",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0082610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• San Judas Medical Group Ipa
• San Judas Medical Group West
• Victor M San Lucas III III, CRNA
• San Lucas Medical Clinic, Inc.
• Kevin San Luis, DNP
• Jacqueline San Nicolas
• San Vicente Surgery Center, LLC
• San Vicente Women'S Total Health Center Inc
• San Vincente Women'S Total Health Center Inc
• Samoan San

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.