Individual provider Active NPI

Atef Samy Tawfik, MD

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1629007067
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036064164 Issued in IL
Practice address
942 S Atlantic Blvd
Los Angeles, CA 90022-4004
Phone
(323) 263-9700
Fax
(323) 263-8042
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036064164 IL Primary

Addresses

Primary practice location

942 S Atlantic Blvd
Los Angeles, CA 90022-4004

Mailing address

942 S Atlantic Blvd
Los Angeles, CA 90022-4004
Phone (323) 263-9700

Other identifiers 1

IdentifierTypeStateIssuer
036064164MedicaidIL

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
I20160315001269 CA Practitioner - Family Practice 8527254374 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince May 2, 2016 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince May 2, 2016 Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

3565 Del Amo Blvd
Torrance, CA 90503

Organizations & group practices 2

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1629007067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224004",
            "telephone_number": "323-263-9700",
            "fax_number": "323-263-8042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 S ATLANTIC BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900224004",
            "telephone_number": "323-263-9700",
            "fax_number": "323-263-8042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAWFIK",
        "first_name": "ATEF",
        "middle_name": "SAMY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036064164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064164",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.