Individual provider Active NPI

Romana Haider, M.D.

  • Legal Medicine
  • Santa Monica, CA
National Provider Identifier
1093755589
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Legal MedicineTaxonomy code 173000000X
License
A78716 Issued in CA
Practice address
2428 Santa Monica Blvd
402
Santa Monica, CA 90404-2045
Phone
(310) 829-3385
Fax
(310) 828-6635
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Legal Medicine 173000000X A78716 CA Primary

Addresses

Primary practice location

2428 Santa Monica Blvd
402
Santa Monica, CA 90404-2045

Mailing address

9613 Kirkside Rd
Los Angeles, CA 90035-4009
Phone (310) 838-8842

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
I20040317000779 CA Practitioner - General Practice 3577453216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2428 Santa Monica Blvd
Suite 402
Santa Monica, CA 90404-2047
Phone (310) 829-3385

Hospital & facility affiliations

  • Saint John'S Health Center Hospital, Santa Monica, CA, CCN 050290

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78716CAMDMental Health Counselor
A78716CAMDLegal Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Westside Primary Care, Inc. Legal Medicine CurrentSince Mar 16, 2006 Accepting new patients
Pacific Multi Specialty Medical Group, Inc. Past Accepting new patients
Thinh T. Le DPM Inc. Past Accepting new patients
Westside Primary Care, Inc. Past Accepting new patients

Locations

2428 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 315-1000

2428 Santa Monica Blvd
Ste 402
Santa Monica, CA 90404
Phone (310) 449-4595

Organizations & group practices 4

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 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1093755589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9613 KIRKSIDE RD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900354009",
            "telephone_number": "310-838-8842",
            "fax_number": "310-838-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 SANTA MONICA BLVD",
            "address_2": "402",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042045",
            "telephone_number": "310-829-3385",
            "fax_number": "310-828-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDER",
        "first_name": "ROMANA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "CA",
            "license": "A78716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.