NPIMap

Individual provider Active NPI

Ali Reza Tajik, M.D.

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1629020268
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A79426 Issued in CA
Practice address
3400 W Ball Rd
Suite 207
Anaheim, CA 92804-3738
Phone
(714) 826-7440
Fax
(714) 821-4329
NPI assigned
May 16, 2006
Last updated
Aug 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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 A79426 CA Primary

Addresses

Primary practice location

3400 W Ball Rd
Suite 207
Anaheim, CA 92804-3738

Mailing address

3400 W Ball Rd
Suite 207
Anaheim, CA 92804-3738
Phone (714) 826-7440

Other names 1

  • Dr. Ali Reza Tajikahmadabad Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401001252 CA Practitioner - Family Practice 0042202764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3400 W Ball Rd
Suite 207
Anaheim, CA 92804-3737
Phone (714) 826-7440

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A79426CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ali R. Tajik, MD, Inc Family Medicine CurrentSince Nov 1, 2005 Accepting new patients
Ali R Tajik MD Inc Family Medicine CurrentSince Nov 1, 2005 Accepting new patients
Orange County Global Medical Center, Inc Past Accepting new patients
St Jude Hospital Inc Past Accepting new patients
Millennium Multispecialty Medical Group Inc Past Accepting new patients
Anaheim Memorial Medical Center Past Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients

Locations

3400 W Ball Rd
Ste 207
Anaheim, CA 92804
Phone (714) 683-5100

2426 S Garfield Ave
Monterey Park, CA 91754
Phone (323) 722-2880

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1629020268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD",
            "address_2": "SUITE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043738",
            "telephone_number": "714-826-7440",
            "fax_number": "714-821-4329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W BALL RD",
            "address_2": "SUITE 207",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928043738",
            "telephone_number": "714-826-7440",
            "fax_number": "714-821-4329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAJIK",
        "first_name": "ALI",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A79426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALI",
            "last_name": "TAJIKAHMADABAD",
            "middle_name": "REZA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.