Sliman Costa Tannous

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

292841 Issued in CA

Practice address

5478 Wilshire Blvd Ste 208
Los Angeles, CA 90036-4225

Phone

(323) 936-7525

NPI assigned

Feb 17, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sliman.tannous.p1@direct.lcthc.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Lake County Tribal Health Consortium Inc.

  • Federally Qualified Health Center (FQHC)
  • Lakeport, CA
  • NPI 1881697381
  Medicare reassignment NPD
• Lake County Tribal Health Southshore Clinic

  • Federally Qualified Health Center (FQHC)
  • Clearlake, CA
  • NPI 1063158038
  NPD
• Body Rehab Center

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1215153747
  NPD (past)

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

{
    "created_epoch": "1487289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1114466521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1950",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954531950",
            "telephone_number": "707-263-8383",
            "fax_number": "707-263-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5478 WILSHIRE BLVD STE 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900364225",
            "telephone_number": "323-936-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Bevins Court",
            "address_purpose": "LOCATION",
            "city": "Lakeport",
            "state": "CA",
            "postal_code": "954539754",
            "country_code": "US",
            "telephone_number": "707-263-8383",
            "fax_number": "707-263-5019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14440 Olympic Drive",
            "address_purpose": "LOCATION",
            "city": "Clearlake",
            "state": "CA",
            "postal_code": "954228809",
            "country_code": "US",
            "telephone_number": "707-263-8383",
            "fax_number": "707-263-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNOUS",
        "first_name": "SLIMAN",
        "middle_name": "COSTA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-17",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "292841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Tanner, PHD
• Colby Boyd Tanner, M.D.
• Kenneth Tanner
• Michael E Tanner
• Stacy Tanner, AUD
• Vanessa Tannous, PHARMD
• Michael Takeshi Tanoue, M.D.
• Ruth S. Tanouye
• Wendy Tanouye, PHARMD
• Daraporn Tanpattana, D.D.S.

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.