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SU SALUD MEDICAL GROUP INC
NPI 1104476217
General Practice in Huntington Park, CA

Active since September 19, 2019CLIA 05D2172755 · Waiver
7418 STATE ST, HUNTINGTON PARK, CA 90255(323) 835-6298(323) 835-6081 Get Directions Write a Review

NPPES record last updated: May 1, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Su Salud Medical Group Inc NPPES

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

SU SALUD MEDICAL GROUP INC (NPI 1104476217) is a healthcare organization registered as a general practice in Huntington Park, California and active in the NPI registry since September 2019. The organization holds a CLIA Waiver certificate valid through September 29, 2027 and lists Abdel N Abdelsayed, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1104476217
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameSU SALUD MEDICAL GROUP INC
Location Address7418 STATE STHuntington Park, CA 90255-5928
Mailing Address7418 State StHuntington Park, CA 90255-5928 · (323) 835-6298 · Fax (323) 835-6081
Phone(323) 835-6298
Fax(323) 835-6081
Organization SubpartNo
Authorized OfficialAbdel N AbdelsayedMedical Director · (323) 918-2700
Enumeration DateSeptember 19, 2019
Last NPPES UpdateMay 1, 2020
NPPES CertifiedMay 1, 2020
✔ NPI 1104476217 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedPediatricsTaxonomy 208000000X
7418 STATE ST, Huntington Park, CA 90255
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Other Identifiers 1

Medicaid1922164961CA

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Su Salud Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Su Salud Medical Group Inc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Adel Abdelsayed, M.D.
General Practice
NPI 1922164961
7418 STATE ST
Huntington Park, CA 90255
(323) 835-6298
✔ PECOS✔ Accepts MedicareSame address
Julio Brizuela, NURSE PRACTITIONER
Nurse Practitioner
NPI 1346002664
7418 STATE ST
Huntington Park, CA 90255
(323) 835-6298
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 05D2172755

Su Salud Medical Group, Inc · Huntington Park, CA
Active · expires Sep 29, 2027
CLIA Number05D2172755
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 30, 2025
Certificate Expiration DateSeptember 29, 2027
Laboratory DirectorAdel N. Abdelsayed
Laboratory Phone(323) 835-6298
Laboratory LocationSu Salud Medical Group, Inc7418 State Street, Huntington Park, CA 90255
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Su Salud Medical Group Inc's NPI number?

The NPI number for Su Salud Medical Group Inc is 1104476217. It was assigned to this organization in the NPPES registry on September 19, 2019.

Where is Su Salud Medical Group Inc located?

Su Salud Medical Group Inc is located at 7418 State St, Huntington Park, CA 90255. The listed phone number is (323) 835-6298.

What is Su Salud Medical Group Inc's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Su Salud Medical Group Inc enrolled in Medicare?

Yes. Su Salud Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Su Salud Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Su Salud Medical Group Inc, in General Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Su Salud Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2172755) is associated with this NPI, valid through September 29, 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 Su Salud Medical Group Inc was last updated on May 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.