Individual provider Active NPI

Iman Abdel Bar, MD

  • Pediatrics Physician
  • Costa Mesa, CA
National Provider Identifier
1326127804
Registry record updated Jan 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A72354 Issued in CA
Practice address
2077 Harbor Blvd
Unit a
Costa Mesa, CA 92627-2630
Phone
(949) 646-3623
NPI assigned
Nov 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2017

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 A72354 CA Primary
General Practice Physician 208D00000X A72354 CA

Addresses

Primary practice location

2077 Harbor Blvd
Unit a
Costa Mesa, CA 92627-2630

Mailing address

2077 Harbor Blvd
Unit a
Costa Mesa, CA 92627-2630
Phone (949) 646-3623

Other identifiers 1

IdentifierTypeStateIssuer
00A723540MedicaidCA

Other names 1

  • Iman Bar Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200110002367 NV Practitioner - Pediatric Medicine 1052586286 Reassigns benefits to 1 organization
I20200221002359 CA Practitioner - Pediatric MedicinePractitioner - General Practice 1052586286 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A72354CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaheim Urgent Care, Inc CurrentSince Dec 28, 2019 Accepting new patients
Anaheim Urgent Care, Inc. Current Accepting new patients
Humboldt General Hospital Current Accepting new patients
Anaheim Urgent Care, Inc CurrentSince Dec 28, 2019 Accepting new patients
Humboldt General Hospital Pharmacy Past Accepting new patients
Hoag Memorial Hospital Presbyterian Past Accepting new patients
Iman Abdel Bar MD Inc Pediatrics PastSince Jul 24, 2022 Accepting new patients

Locations

831 S State College Blvd
Anaheim, CA 92806
Phone (714) 533-2273

5717 Melrose Ave
Los Angeles, CA 90038
Phone (323) 957-2273

888 S Figueroa St
Ste 600
Los Angeles, CA 90017

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484265600000",
    "number": "1326127804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2077 HARBOR BLVD",
            "address_2": "UNIT A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272630",
            "telephone_number": "949-646-3623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2077 HARBOR BLVD",
            "address_2": "UNIT A",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926272630",
            "telephone_number": "949-646-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAR",
        "first_name": "IMAN",
        "middle_name": "ABDEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2017-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A72354",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A72354",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A723540",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IMAN",
            "last_name": "BAR",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Costa Mesa, CA

Sources for this page

Verify at the official NPI Registry.