1. Home
  2. Directory
  3. California
  4. Loma Linda
  5. Pediatrics
  6. NPI Profile

DR. MOHAMED ALI HASSAN GHANDOUR MD
NPI 1831683143
Pediatrics - Pediatric Cardiology in Loma Linda, CA

Active since June 20, 2018PECOS Enrolled
11234 ANDERSON ST, LOMA LINDA, CA 92350(567) 694-5980 Get Directions Write a Review

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 30, 2026, Jun 29, 2021, Jun 20, 2018 (3 updates tracked since 2018).

About Dr. Mohamed Ali Hassan Ghandour Md NPPES

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

DR. MOHAMED ALI HASSAN GHANDOUR MD (NPI 1831683143) is an individual pediatric cardiology provider in Loma Linda, California, licensed in California (A175102) and active in the NPI registry since June 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1831683143
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameDR. MOHAMED ALI HASSAN GHANDOURCredential: MD
Location Address11234 ANDERSON STLoma Linda, CA 92350-1716
Mailing Address11234 Anderson StLoma Linda, CA 92350-1716 · (567) 694-5980
Phone(567) 694-5980
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJune 20, 2018
Last NPPES UpdateFebruary 24, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 24, 2026
✔ NPI 1831683143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in CA · A175102
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Also ListedPediatricsTaxonomy 208000000X · License 4301508826 (MI)
11234 ANDERSON ST, Loma Linda, CA 92350
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mohamed Ali Hassan Ghandour Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7719236280
PECOS Enrollment IDI20251215001666
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Mohamed Ali Ghandour reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Faculty Physicians And Surgeons Of Llusm
Same address
Pediatrics
11234 ANDERSON ST
Loma Linda, CA 92350
  • Reassigned Medicare billing, California enrollment
  • 2,584 clinicians in this Medicare group
NPI 1477503407 (909) 558-4000
Sac Health System
3.7 mi
Federally Qualified Health Center (FQHC)
1454 E 2ND ST
San Bernardino, CA 92408
  • Reassigned Medicare billing, California enrollment
  • 455 clinicians in this Medicare group
NPI 1013935915 (909) 382-7100
University Pediatricians
1,933 mi
Nurse Practitioner
3901 BEAUBIEN
Detroit, MI 48201
  • Reassigned Medicare billing, Michigan enrollment
  • 360 clinicians in this Medicare group
NPI 1033143904 (313) 745-5214

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

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.

DR. THUCAN TIMOTHY BUI DO
Emergency Medicine
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4344
VAHE YACOUBIAN MD, MPH
Orthopaedic Surgery
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (818) 813-4234
AISHA Q EALEY APRN, ACCCNS-N
Clinical Nurse Specialist (Neonatal)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4248
MR. RANDAL KEITH GILMAN PA
Physician Assistant
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4475
AMR AZZAM MD, PHD
Ophthalmology (Retina Specialist)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-2182
DARSH THAKRAR M.D.
Radiology (Diagnostic Radiology)
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4000
HAITHAM SIAG MBBCH
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (914) 267-6104
PRESTON ANDREW SHIRSAT
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92350
San Bernardino County (909) 558-4074

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 Mohamed Ali Ghandour's NPI number?

The NPI number for Mohamed Ali Ghandour is 1831683143. It was assigned to this individual provider in the NPPES registry on June 20, 2018.

Where is Mohamed Ali Ghandour located?

Mohamed Ali Ghandour practices at 11234 Anderson St, Loma Linda, CA 92350. The listed phone number is (567) 694-5980.

What is Mohamed Ali Ghandour's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Mohamed Ali Ghandour enrolled in Medicare?

Yes. Mohamed Ali Ghandour is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mohamed Ali Ghandour's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mohamed Ali Ghandour reassigns Medicare benefits to 3 organizations: Faculty Physicians And Surgeons Of Llusm (Loma Linda, CA), Sac Health System (San Bernardino, CA) and University Pediatricians (Detroit, MI). Each 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 Mohamed Ali Ghandour's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mohamed Ali Ghandour was last updated on February 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.