Organization Active NPI

Adel S. Metry,M.D. Inc.

  • Cardiovascular Disease Physician
  • Gardena, CA
National Provider Identifier
1932308194
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
ADEL S. METRY,M.D. INC.
Practice address
1141 W Redondo Beach Blvd
#406
Gardena, CA 90247
Phone
(310) 719-1653
Fax
(310) 719-1321
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Adel S MetryNPI 1376638809
Title
President
Phone
(310) 719-1653

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

1141 W Redondo Beach Blvd
#406
Gardena, CA 90247

Mailing address

1141 W Redondo Beach Blvd
#406
Gardena, CA 90247
Phone (310) 719-1653

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080508000425 CA Part B Supplier - Clinic/Group Practice 7911086467 Receives reassigned benefits from 1 practitioner
Practice locations: Gardena, CA

National Provider Directory

National Provider Directory

Locations

1141 W Redondo Beach Blvd
Ste 406
Gardena, CA 90247
Phone (310) 515-1055

Practitioners & affiliated clinicians

Practitioners 2

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": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1932308194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "#406",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-719-1653",
            "fax_number": "310-719-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 W REDONDO BEACH BLVD",
            "address_2": "#406",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "90247",
            "telephone_number": "310-719-1653",
            "fax_number": "310-719-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADEL S. METRY,M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "METRY",
        "authorized_official_first_name": "ADEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-719-1653"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.