ANGELES MEDICAL CLINIC, INC.
NPI 1528344686
Family Medicine in Los Angeles, CA
About Angeles Medical Clinic, Inc. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANGELES MEDICAL CLINIC, INC. (NPI 1528344686) is a healthcare organization registered as a family medicine in Los Angeles, California and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through February 28, 2028 and lists Sarvenaz Saadat Mobasser, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Angeles Medical Clinic, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Angeles Medical Clinic, Inc., which bills Medicare for the services this clinician delivers.
Clinician (1)
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 05D2037476
Angeles Medical Clinic Inc · Los Angeles, CAFrequently 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 Angeles Medical Clinic, Inc.'s NPI number?
The NPI number for Angeles Medical Clinic, Inc. is 1528344686. It was assigned to this organization in the NPPES registry on November 2, 2011.
Where is Angeles Medical Clinic, Inc. located?
Angeles Medical Clinic, Inc. is located at 204 E Pico Blvd, Los Angeles, CA 90015. The listed phone number is (213) 457-4000.
What is Angeles Medical Clinic, Inc.'s specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Angeles Medical Clinic, Inc. enrolled in Medicare?
Yes. Angeles Medical Clinic, Inc. is registered in the Medicare PECOS enrollment system.
When is Angeles Medical Clinic, Inc.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Angeles Medical Clinic, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Angeles Medical Clinic, Inc.. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Angeles Medical Clinic, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2037476) is associated with this NPI, valid through February 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Angeles Medical Clinic, Inc. was last updated on September 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Angeles Medical Clinic, Inc. · NPI 1528344686
Family Medicine organization in Los Angeles, California. Organization record, active in the CMS NPPES registry since November 2, 2011.
## Identity
- **NPI:** 1528344686 (Entity type: Organization)
- **Enumerated:** November 2, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Sarvenaz Mobasser, PRESIDENT
## Practice location
- **Address:** 204 E PICO BLVD, Los Angeles, CA 90015-2508
- **Phone:** (213) 457-4000 · **Fax:** (213) 457-6000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 11, 2012
- **Other identifiers:** Medicare PIN FB348A (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1528344686) · Data from the CMS NPPES public registry.