Mariam Wahib Fahim, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A3290 Issued in CA

Practice address

36243 Inland Valley Dr
Suite 80
Wildomar, CA 92595-9549

Phone

(951) 813-3760

Fax

(951) 813-3761

NPI assigned

Nov 14, 2006

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12407/brand/1/csg/1/fhir/r4
• Direct secure messaging: mfahim181911@direct.llu.edu
• Direct secure messaging: mariam.fahim.1@12407.direct.athenahealth.com

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.

• Inscriptions Children'S Clinic

  • Pediatrics Physician
  • Wildomar, CA
  • NPI 1235431172
  NPD (past) Authorized official

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1376615781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR",
            "address_2": "SUITE 80",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959549",
            "telephone_number": "951-813-3760",
            "fax_number": "951-813-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR",
            "address_2": "SUITE 80",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959549",
            "telephone_number": "951-813-3760",
            "fax_number": "951-813-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHIM",
        "first_name": "MARIAM",
        "middle_name": "WAHIB",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A3290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaylah Espinoza
• Francis Essien, M.D.
• Naara Vidales Estrella
• Ricardo Europa
• Heather Evans, RBT
• Jeffrey Labandelo Fajardo, PHARMD
• Jordan Falk
• Liggy Fang
• Courtney Ann Noel Faught, PA-C
• Miriam Felix Campista

• Pediatrics Physician in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.