Unknown Individual – Critical Care Medicine (Internal Medicine) Physician, NPI 1104871011

Critical Care Medicine (Internal Medicine) Physician

Unknown Individual is a healthcare provider. based in Mission hills, California. specializing in Critical Care Medicine (Internal Medicine) Physician. They hold a License No. C53745 (CA). The NPI Number for Unknown Individual is 1104871011

Main info

Organization

Inactive

31 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1104871011

Phone

(818) 837-5559

Address

PO BOX 9602

Deactivation Date

28 November 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7604993899

Graduation Year

1995 (31 years ago)

PAC ID

7719977289

Group Practice PAC ID

9739099896

Professional Enrollment ID

I20100623000588

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience23

Completeness75

Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

Mission, Kiara Hills, Kuala Lumpur, 60000, Malaysia
MISSION HILLS, CA 913469602
Phone: (818) 837-5559
Fax: (818) 792-4793
Type: Mailing
Sepulveda Boulevard, Mission Hills, Los Angeles, Los Angeles County, California, 91345, United States
MISSION HILLS, CA 913451116
Phone: (818) 837-5785
Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 91346)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 9739099896View full group profile

Name	Specialty	State
KELLY ANN DOTY (PA)	Physician Assistant	CA
ALESSA DANYEL SILER (FNP)	Nurse Practitioner	CA
DR. HANI CHAABO (M.D.)	-	WV
ANDREW MODIC (MD)	Internal Medicine	CA
MR. RENE SALINAS (CRNA)	Certified Registered Nurse Anesthetist (Crna)	NM
TODD ROWLAND (MSN, RN, FNP-C, CEN)	-	CA
VICTORIA SCHAUF (MD)	-	CA
MARIAH ARLENE PIETRANGELO (WHNP)	Nurse Practitioner	CA
DR. RAY N ISKANDER (MD)	-	CA
CAROL A KENDALL (N.P.)	Nurse Practitioner	CA

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?

You can start verification with NPI 1104871011 for Unknown Individual, then check state licensing separately.

Why might Unknown Individual appear inactive while still practicing?

We display what the registry publishes: Unknown Individual appears inactive there.

What is Unknown Individual best known for clinically?

Directory data describes Unknown Individual with Critical Care Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Mission Hills, California as a primary anchor for Unknown Individual unless the record lists multiple sites.

Is specialty guaranteed by NPI alone?

Taxonomy selections describe intent; scope of practice still follows state law.