Acessmd Medical Group, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A47792 Issued in CA

Legal business name

ACESSMD MEDICAL GROUP, INC

Practice address

17220 Newhope St
#125
Fountain Valley, CA 92708-4272

Phone

(714) 435-0600

NPI assigned

Dec 28, 2010

Last updated

Dec 28, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adel A Boutros, MDNPI 1700952827

Title

President

Phone

(714) 317-3084

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adel Boutros, MD

  • Family Medicine Physician
  • Lake Forest, CA
  • NPI 1700952827
  NPD (past) Authorized official

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1932403441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8095",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927288095",
            "telephone_number": "949-951-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17220 NEWHOPE ST",
            "address_2": "#125",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084272",
            "telephone_number": "714-435-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACESSMD MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "BOUTROS",
        "authorized_official_first_name": "ADEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-317-3084",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A47792",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G32104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald G M Abraham, M D
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• Acceptance Detox LLC (Acceptance Detox & Treatment Services)
• Keith Ryan Aceron, DPM
• Cecilia Rosete Acosta
• Olivia Marie Acosta
• Victoria A Acosta
• Active Care Pharmacy Inc (Active Care Pharmacy)
• Adam Wong MD Inc

• Family Medicine Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.