Amgad R Elsibai MD Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A52784 Issued in CA

Legal business name

AMGAD R ELSIBAI MD INC

Practice address

16055 Ventura Blvd Ste 1000
Encino, CA 91436-2611

Phone

(310) 621-1332

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Amgad R Elsibai, MD

Title

Owner Pres

Phone

(310) 621-1332

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1497776355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5486",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928635486",
            "telephone_number": "818-550-0900",
            "fax_number": "818-550-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16055 VENTURA BLVD STE 1000",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362611",
            "telephone_number": "310-621-1332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18321 Clark Street",
            "address_purpose": "LOCATION",
            "city": "Tarzana",
            "state": "CA",
            "postal_code": "913563501",
            "country_code": "US",
            "telephone_number": "818-708-5285",
            "fax_number": "818-708-5491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMGAD R ELSIBAI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "ELSIBAI",
        "authorized_official_first_name": "AMGAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER PRES",
        "authorized_official_telephone_number": "310-621-1332",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A52784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A527841",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.