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: August 02, 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
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

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

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.

Other Providers at the Same Location NPPES 3

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

Physician Assistant
7418 STATE ST
HUNTINGTON PARK, CA 90255
Nurse Practitioner (Family)
7418 STATE ST
HUNTINGTON PARK, CA 90255
General Practice
7418 STATE ST
HUNTINGTON PARK, CA 90255

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.

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.