Organization Active NPI

Libra Pain Care

  • Interventional Pain Medicine Physician
  • West Covina, CA
National Provider Identifier
1477952117
Registry record updated Feb 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
A126658 Issued in CA
Legal business name
LIBRA PAIN CARE
Practice address
1433 W Merced Ave Ste 103
West Covina, CA 91790-3402
Phone
(626) 506-2648
Fax
(626) 898-9250
NPI assigned
Aug 19, 2014
Last updated
Feb 4, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2026

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

Authorized official

Name
Dr. Sam Ahdab, M.D.NPI 1992941397
Title
President
Phone
(323) 217-2856

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A126658 CA
Pain Medicine Physician 208VP0000X A126658 CA
Interventional Pain Medicine Physician 208VP0014X A126658 CA Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X A126658 CA

Addresses

Primary practice location

1433 W Merced Ave Ste 103
West Covina, CA 91790-3402

Mailing address

1433 W Merced Ave Ste 103
West Covina, CA 91790-3402
Phone (626) 506-2648

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150928000799 CA Part B Supplier - Clinic/Group Practice 9931417805 Receives reassigned benefits from 1 practitioner
Practice locations: West Covina, CA

National Provider Directory

National Provider Directory

Locations

1433 W Merced Ave
Ste 103
West Covina, CA 91790
Phone (626) 337-8000

1433 W Merced Ave
Ste 324
West Covina, CA 91790
Phone (626) 960-8877

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1477952117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1433 W MERCED AVE STE 103",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903402",
            "telephone_number": "626-506-2648",
            "fax_number": "626-898-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1433 W MERCED AVE STE 103",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903402",
            "telephone_number": "626-506-2648",
            "fax_number": "626-898-9250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBRA PAIN CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "AHDAB",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-217-2856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A126658",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "A126658",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "A126658",
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "A126658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.