Active NPI
Siar Ahmad Basharmal, M.D.
- Internal Medicine Physician
- Gardena, CA
National Provider Identifier
1639168099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A91350
- Practice address
- 1251 W Redondo Beach Blvd
Gardena, CA 90247-3456 - Phone
- (310) 851-4705
- NPI assigned
- Oct 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A91350 | CA | Primary |
Addresses
Primary practice location
1251 W Redondo Beach Blvd
Gardena, CA 90247-3456
Mailing address
1006 Butternut CT
Carson, CA 90746-7488
Phone (310) 851-4705
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140923002537 | CA | Order and Referring Only - Internal Medicine | 7416176433 |
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
18200 Yorba Linda Blvd
Suite 111
Yorba Linda, CA 92886-4043
4682 Valencia Ave
Yorba Linda, CA 92886-2443
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 91350 | CA | MD | Pharmacist |
| A91350 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129593600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1243814400000",
"number": "1639168099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 BUTTERNUT CT",
"city": "CARSON",
"state": "CA",
"postal_code": "907467488",
"telephone_number": "310-851-4705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 W REDONDO BEACH BLVD",
"city": "GARDENA",
"state": "CA",
"postal_code": "902473456",
"telephone_number": "310-851-4705"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASHARMAL",
"first_name": "SIAR",
"middle_name": "AHMAD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-18",
"last_updated": "2009-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "A91350",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.