Individual provider Active NPI

Tahira Malik, M.D.

  • Pediatrics Physician
  • San Jose, CA
National Provider Identifier
1376645739
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A45070 Issued in CA
Practice address
2585 Samaritan Dr
San Jose, CA 95124-4107
Phone
(408) 871-3400
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A45070 CA Primary

Addresses

Primary practice location

2585 Samaritan Dr
San Jose, CA 95124-4107

Mailing address

2585 Samaritan Dr
San Jose, CA 95124-4107
Phone (408) 871-3400

Other identifiers 1

IdentifierTypeStateIssuer
00A450700MedicaidCA

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
I20080717000543 CA Practitioner - Pediatric MedicinePractitioner - General Practice 0244303626 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
El Camino Health Medical Network, LLC CurrentSince Apr 1, 2019 Accepting new patients
Verity Medical Foundation CurrentSince Dec 1, 2012 Accepting new patients
DCHS Medical Foundation Pediatrics CurrentSince Dec 1, 2012 Accepting new patients
El Camino Hospital Past Accepting new patients
El Camino Health Medical Group Past Accepting new patients
County of Santa Clara Past Accepting new patients
Good Samaritan Hospital, L.P. Past Accepting new patients

Locations

9360 No Name Uno
Ste 125
Gilroy, CA 95020
Phone (408) 846-9444

815 Pollard Rd
Los Gatos, CA 95032
Phone (408) 378-6131

230 S Main St
Ste 100
Orange, CA 92868
Phone (714) 541-0101

9360 N Name Uno
San Francisco, CA 94139
Phone (408) 278-3003

400 Race St
San Jose, CA 95126

2577 Samaritan Dr
Ste 860
San Jose, CA 95124
Phone (408) 358-2627

625 Lincoln Ave
San Jose, CA 95126
Phone (408) 278-3003

2585 Samaritan Dr
San Jose, CA 95124
Phone (408) 278-3003

Interoperability endpoints

  • Direct secure messaging: tmalik49627@icare.elcaminohospital.org

Organizations & group practices 7

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1376645739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244107",
            "telephone_number": "408-871-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244107",
            "telephone_number": "408-871-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALIK",
        "first_name": "TAHIRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A45070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A450700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.