SU SALUD MEDICAL GROUP INC (NPI# 1104476217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104476217 |
| Entity Type | Organization |
| Organization Name | SU SALUD MEDICAL GROUP INC |
| Practice Address |
7418 State St Huntington Park CA 90255-5928 |
| Practice Telephone | 3238356298 |
| Practice Fax Number | 3238356081 |
| Mailing Telephone | 3238356298 |
| Mailing Fax Number | 3238356081 |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2020-05-01 |
| Authorized Official Name | ABDEL N ABDELSAYED (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3239182700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1922164961 | 05 |
| Street Address |
7418 STATE ST |
| City | HUNTINGTON PARK |
| State | CA |
| Zip Code | 90255-5928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922659424 | Maria Hurtado | Behavior Technician | California St & Pacific Blvd, Walnut Park, CA 90255 | 2019-09-25 |
| 1356803555 | Cdf Centro De Desarrollo Familiar | Social Worker | 2677 Zoe Ave Suite 120, Huntington Park, CA 90255 | 2019-04-05 |
| 1710457908 | Toure Marshawn Curry | Rehabilitation Practitioner | 2677 Zoe Ave #304, Huntington Park, CA 90255 | 2018-11-29 |
| 1508366584 | Kalie Marie Baker | Optometrist | 2614 Gage Ave, Huntington Park, CA 90255 | 2018-02-16 |
| 1134633027 | Alicia Rizkalla | Case Manager/Care Coordinator | Altamed Pace, 1900 Slauson Street, Huntington Park, CA 90255 | 2017-11-30 |
| 1205353760 | All Care One Community Health Center | Chiropractor | 7300 Santa Fe Avenue, Huntington Park, CA 90255 | 2017-08-25 |
| 1447613559 | Peter Vue | Respiratory Therapist, Certified | 6208 Seville Ave., Huntington Park, CA 90255 | 2016-04-05 |
| 1558720029 | Dr. Edmond Janfaza Dds, Inc. | Dentist | 2675 E. Slauson Ave, #300, Huntington Park, CA 90255 | 2016-02-12 |
| 1649650979 | Samuel Zaki Dds Inc | Dentist | 7221 Pacific Blvd, Huntington Park, CA 90255 | 2015-06-02 |
| 1376945808 | Karla Zuniga | Case Manager/Care Coordinator | 3638 E 61st Street, Huntington Park, CA 90255 | 2014-09-16 |
| Find all providers in zip 90255 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477069375 | Gage Medical Clinic Inc | General Practice | 3203 E. Florence Ave., Huntington Park, CA 90255-3008 | 2017-12-15 |
| 1093128688 | Peyman Banooni Medical Group Inc. | General Practice | 6120 Seville Ave, Unit B, Huntington Park, CA 90255-2911 | 2014-06-11 |
| 1245655240 | La Libertad Medical Clinic Inc | General Practice | 7900 Pacific Blvd, Huntington Park, CA 90255-6662 | 2014-02-27 |
| 1629251541 | South Atlantic Medical Group | General Practice | 2616 Clarendon Ave, Huntington Park, CA 90255-4120 | 2007-12-13 |
| 1316135742 | Maria Christina Hernandez | General Practice | 3355 E Gage Ave, Huntington Park, CA 90255-5530 | 2007-10-10 |
| 1780808188 | Pedro H Ferrer | General Practice | 7511 State St, 7511 State St, Huntington Park, CA 90255-6132 | 2007-04-13 |
| 1073641098 | Jang Kil Yi | General Practice | 5914 Pacific Bl, Huntington Park, CA 90255-2929 | 2007-03-01 |
| 1619020724 | Iradj H Nazarian Md Inc | General Practice | 7136 Pacific Blvd, Ste 225, Huntington Park, CA 90255-4783 | 2007-01-19 |
| 1689741241 | Haydee G Castaneda | General Practice | 2955 E Florence Ave, Huntington Park, CA 90255-5836 | 2006-11-29 |
| 1376612424 | Charles Sassoon | General Practice | 7723 Pacific Blvd, Huntington Park, CA 90255-6301 | 2006-11-06 |
| Find all providers in HUNTINGTON PARK | ||||
| City | HUNTINGTON PARK |
| Zip Code | 90255 |
Please comment or provide details below to improve the information on SU SALUD MEDICAL GROUP INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.