Individual provider Active NPI

Sonam Tanna Sidhu

  • Pediatric Critical Care Medicine Physician
  • West Hollywood, CA
National Provider Identifier
1114381803
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
A152602 Issued in CA
Practice address
8700 Beverly Blvd Ste 4221
West Hollywood, CA 90048-1804
Phone
(310) 423-6310
NPI assigned
Apr 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A152602 CA
Pediatric Critical Care Medicine Physician 2080P0203X A152602 CA Primary

Addresses

Primary practice location

8700 Beverly Blvd Ste 4221
West Hollywood, CA 90048-1804

Mailing address

4140 W 190TH St
Torrance, CA 90504-5513

Other practice location 1

505 S Main St
Suite 525
Orange, CA 92868-4509
Phone (714) 456-5631

Other names 1

  • Sonam B Tanna Former name

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
I20220729001280 CA Practitioner - Pediatric Medicine 4183979073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.23 of 100Reported as group
Quality
77.83
Promoting interoperability
98
Improvement activities
40
Cost
71.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A152602CAMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2022 Accepting new patients
Cedars-Sinai Medical Center CurrentSince Jul 1, 2022 Accepting new patients
University of California Irvine Past Accepting new patients

Locations

4140 W 190th St
Torrance, CA 90504
Phone (310) 967-1780

8700 Beverly Blvd
Ste 4221
West Hollywood, CA 90048
Phone (310) 423-4451

8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1114381803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W 190TH ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905045513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 BEVERLY BLVD STE 4221",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "900481804",
            "telephone_number": "310-423-6310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S Main St",
            "address_2": "Suite 525",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928684509",
            "country_code": "US",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "SONAM",
        "middle_name": "TANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A152602",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A152602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SONAM",
            "last_name": "TANNA",
            "middle_name": "B",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Hollywood, CA

Sources for this page

Verify at the official NPI Registry.