Individual provider Active NPI

Siamak Tabib, M.D.

  • Gastroenterology Physician
  • Los Angeles, CA
National Provider Identifier
1063555845
Registry record updated Dec 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
A66169 Issued in CA
Practice address
8631 W 3Rd St
Suite 1015E
Los Angeles, CA 90048-5901
Phone
(310) 652-4472
Fax
(310) 358-2266
NPI assigned
Feb 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X A66169 CA Primary

Addresses

Primary practice location

8631 W 3Rd St
Suite 1015E
Los Angeles, CA 90048-5901

Mailing address

8631 W 3Rd St
Suite 1015E
Los Angeles, CA 90048-5901
Phone (310) 652-4472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120614000045 CA Practitioner - Gastroenterology 9537109921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
University of California, Geffen School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8631 W 3Rd St
Suite 1015E
Los Angeles, CA 90048-5925
Phone (310) 652-4472

Hospital & facility affiliations

  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy96
Upper gastrointestinal (GI) endoscopy for acid reflux82

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A66169CAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Path MD Inc CurrentSince Jan 1, 2024 Accepting new patients
Siamak Tabib MD Inc Gastroenterology CurrentSince Feb 28, 2003 Accepting new patients

Locations

8158 Beverly Blvd
Los Angeles, CA 90048
Phone (310) 489-5615

8631 W 3rd St
Ste 1015E
Los Angeles, CA 90048
Phone (310) 614-3897

8631 W 3rd St
#1015E
Los Angeles, CA 90048
Phone (310) 652-4472

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356566400000",
    "number": "1063555845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST",
            "address_2": "SUITE 1015E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-652-4472",
            "fax_number": "310-358-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8631 W 3RD ST",
            "address_2": "SUITE 1015E",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485901",
            "telephone_number": "310-652-4472",
            "fax_number": "310-358-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABIB",
        "first_name": "SIAMAK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2012-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A66169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.