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JASON K BOUTROS M D INC
NPI 1053532580
Internal Medicine in Pasadena, CA

Active since May 01, 2007CLIA 05D0906600 · Waiver
2750 E WASHINGTON BLVD, SUITE 260, PASADENA, CA 91107(626) 798-8923(626) 798-0258 Get Directions Write a Review

NPPES record last updated: January 28, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jason K Boutros M D Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JASON K BOUTROS M D INC (NPI 1053532580) is a healthcare organization registered as an internal medicine in Pasadena, California and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through October 2, 2027 and lists Cindy Chon, Administrator, as its authorized official.

NPPES Registry Identity

NPI1053532580
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameJASON K BOUTROS M D INC
Location Address2750 E WASHINGTON BLVD, SUITE 260Pasadena, CA 91107-1448
Mailing Address2750 E Washington Blvd, Suite 260Pasadena, CA 91107-1448 · (626) 798-8923 · Fax (626) 798-0258
Phone(626) 798-8923
Fax(626) 798-0258
Organization SubpartNo
Authorized OfficialCindy ChonAdministrator · (626) 798-8923
Enumeration DateMay 1, 2007
Last NPPES UpdateJanuary 28, 2011
✔ NPI 1053532580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · A42891
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
2750 E WASHINGTON BLVD, Pasadena, CA 91107
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Other Identifiers 4

Medicare ID-Type UnspecifiedW13909CA
Medicare UPINC04014CA
MedicaidGR0076360CA
Medicare PINW13909ACA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0906600

Jason Boutros, MD Inc · Pasadena, CA
Active · expires Oct 2, 2027
CLIA Number05D0906600
Laboratory TypePhysician Office
Certificate Effective DateOctober 3, 2025
Certificate Expiration DateOctober 2, 2027
Laboratory DirectorJason Boutros
Laboratory Phone(626) 798-8923
Laboratory LocationJason Boutros, MD Inc2554 E Washington Blvd Ste A, Pasadena, CA 91107
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AURELIE ANNE MARIE ZEPHIR
Marriage & Family Therapist
2750 E WASHINGTON BLVD
PASADENA, CA 91107
Los Angeles County (626) 296-8900
D'VEAL FAMILY & YOUTH SERVICES
Community/Behavioral Health
2750 E WASHINGTON BLVD, SUITE 230, 240, 250, 260
PASADENA, CA 91107
Los Angeles County (626) 296-8900
CLIFTON A MAYBERRY MD
Specialist
2750 E WASHINGTON BLVD, STE 330
PASADENA, CA 91107
Los Angeles County (626) 797-9883
ALEXIS CHRISTINE HERNANDEZ
Social Worker (Clinical)
2750 E WASHINGTON BLVD
PASADENA, CA 91107
Los Angeles County (626) 296-8900
MRS. EVONNE R MEZA IMF
Marriage & Family Therapist
2750 E WASHINGTON BLVD
PASADENA, CA 91107
Los Angeles County (626) 296-8900
ALVARO REYNALDO COTA
Student in an Organized Health Care Education/Training Program
2750 E WASHINGTON BLVD
PASADENA, CA 91107
Los Angeles County (626) 296-8900
JOCELYN CANALES
Student in an Organized Health Care Education/Training Program
2750 E WASHINGTON BLVD
PASADENA, CA 91107
Los Angeles County (626) 296-8900
LIONEL P NG MD
Pediatrics
2750 E WASHINGTON BLVD, #360
PASADENA, CA 91107
Los Angeles County (626) 794-8024

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jason K Boutros M D Inc's NPI number?

The NPI number for Jason K Boutros M D Inc is 1053532580. It was assigned to this organization in the NPPES registry on May 1, 2007.

Where is Jason K Boutros M D Inc located?

Jason K Boutros M D Inc is located at 2750 E Washington Blvd Suite 260, Pasadena, CA 91107. The listed phone number is (626) 798-8923.

What is Jason K Boutros M D Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Jason K Boutros M D Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0906600) is associated with this NPI, valid through October 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jason K Boutros M D Inc was last updated on January 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.