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CLINICA MEDICA PACOIMA
NPI 1649038985
Internal Medicine in Pacoima, CA

Active since March 11, 2024CLIA 05D2315876 · Waiver
13630 VAN NUYS BLVD STE 107, PACOIMA, CA 91331(747) 777-6099(747) 227-3076 Get Directions Write a Review

NPPES record last updated: March 24, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Clinica Medica Pacoima NPPES

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

CLINICA MEDICA PACOIMA (NPI 1649038985) is a healthcare organization registered as an internal medicine in Pacoima, California and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through December 19, 2026 and lists Stefan Ruehm, President, as its authorized official.

NPPES Registry Identity

NPI1649038985
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameCLINICA MEDICA PACOIMA
Location Address13630 VAN NUYS BLVD STE 107Pacoima, CA 91331-3668
Mailing Address13630 Van Nuys Blvd Ste 107Pacoima, CA 91331-3668 · (747) 777-6099 · Fax (747) 227-3076
Phone(747) 777-6099
Fax(747) 227-3076
Organization SubpartNo
Authorized OfficialStefan RuehmPresident · (747) 777-6099
Enumeration DateMarch 11, 2024
Last NPPES UpdateMarch 24, 2025
NPPES CertifiedMarch 24, 2025
✔ NPI 1649038985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
Also ListedClinic/Center · RadiologyTaxonomy 261QR0200X
13630 VAN NUYS BLVD STE 107, Pacoima, CA 91331
Open in Google Maps ↗

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)

Clinica Medica Pacoima 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 Clinica Medica Pacoima, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Siranush Grigoryan
Nurse Practitioner
NPI 1093582546
13630 VAN NUYS BLVD
Pacoima, CA 91331
(747) 888-2584
✔ PECOS✔ Accepts MedicareSame address
Stefan Ruehm, MD
Diagnostic Radiology
NPI 1669416632
100 UCLA MEDICAL PLZ STE 100
Los Angeles, CA 90024
(310) 301-6800
✔ PECOS✔ Accepts Medicare13 mi

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 05D2315876

Clinica Medica Pacoima · Pacoima, CA
Active · expires Dec 19, 2026
CLIA Number05D2315876
Laboratory TypePhysician Office
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorStefan Ruehm
Laboratory Phone(747) 777-6099
Laboratory LocationClinica Medica Pacoima13630 Van Nuys Blvd Ste 107, Pacoima, CA 91331
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 Clinica Medica Pacoima's NPI number?

The NPI number for Clinica Medica Pacoima is 1649038985. It was assigned to this organization in the NPPES registry on March 11, 2024.

Where is Clinica Medica Pacoima located?

Clinica Medica Pacoima is located at 13630 Van Nuys Blvd Ste 107, Pacoima, CA 91331. The listed phone number is (747) 777-6099.

What is Clinica Medica Pacoima's specialty?

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

Is Clinica Medica Pacoima enrolled in Medicare?

Yes. Clinica Medica Pacoima is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Clinica Medica Pacoima?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Clinica Medica Pacoima, in Diagnostic Radiology 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, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Clinica Medica Pacoima hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2315876) is associated with this NPI, valid through December 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Clinica Medica Pacoima was last updated on March 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months 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.