| Badr Medical Corporation | |
|
1500 E Chevy Chase Dr Ste 204 Glendale CA 91206-4152 | |
| (818) 827-3898 | |
| (818) 827-3897 |
| Full Name | Badr Medical Corporation |
|---|---|
| Speciality | Neurological Surgery |
| Location | 1500 E Chevy Chase Dr Ste 204, Glendale, California |
| Authorized Official Name and Position | Yaser Badr (PRESIDENT) |
| Authorized Official Contact | 8188273898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Badr Medical Corporation Po Box 41926 Los Angeles CA 90041-0926 Ph: (818) 562-6400 | Badr Medical Corporation 1500 E Chevy Chase Dr Ste 204 Glendale CA 91206-4152 Ph: (818) 827-3898 |
| NPI Number | 1871920652 |
|---|---|
| Provider Enumeration Date | 10/10/2013 |
| Last Update Date | 11/22/2019 |
| Medicare PECOS PAC ID | 4183855083 |
|---|---|
| Medicare Enrollment ID | O20140318000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871920652 | NPI | - | NPPES |
| 1275724320 | Other | CA | NPI |
| 1507881 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 207T00000X | Neurological Surgery | (* (Not Available)) | Primary |
| Provider Name | Yaser Badr |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275724320 PECOS PAC ID: 8426286451 Enrollment ID: I20140318000341 |
| Provider Name | Jared Daniel Ament |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356653927 PECOS PAC ID: 3779700125 Enrollment ID: I20140808001500 |
| Provider Name | Mikayel Grigoryan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801003686 PECOS PAC ID: 3476700162 Enrollment ID: I20170208002020 |
| Provider Name | Enrique D Gomez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164945564 PECOS PAC ID: 1153697560 Enrollment ID: I20171030000710 |
| Provider Name | Oliver Tagamolila Rago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720588908 PECOS PAC ID: 4880938588 Enrollment ID: I20181206003245 |
| Provider Name | Erika Aguilar Marroquin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487323200 PECOS PAC ID: 5193115319 Enrollment ID: I20211214003149 |
| Provider Name | Anais Yeghyaian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790553675 PECOS PAC ID: 7416499009 Enrollment ID: I20240611002117 |
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