Organization Active NPI

Taher Saifullah MD a Professional Medical Corporation

  • Pain Medicine (Anesthesiology) Physician
  • Pasadena, CA
National Provider Identifier
1679176754
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
TAHER SAIFULLAH MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
625 S Fair Oaks Ave Ste 230
Pasadena, CA 91105-2663
Phone
(626) 469-2939
Fax
(626) 469-2956
NPI assigned
Nov 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
Taher Saifullah, MDNPI 1871939587
Title
Owner
Phone
(909) 524-1041

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

625 S Fair Oaks Ave Ste 230
Pasadena, CA 91105-2663

Mailing address

625 S Fair Oaks Ave Ste 230
Pasadena, CA 91105-2663
Phone (626) 469-2939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210419002438 CA Part B Supplier - Clinic/Group Practice 0244648970 Receives reassigned benefits from 2 practitioners
Practice locations: Pasadena, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2219088Taher Saifullah MD, a Professional625 S Fair Oaks Ave Ste #230, Pasadena, CA 91105Certificate of waiverMar 31, 2027

National Provider Directory

National Provider Directory

Locations

625 S Fair Oaks Ave
Ste 230
Pasadena, CA 91105
Phone (626) 395-9588

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1679176754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 230",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052663",
            "telephone_number": "626-469-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S FAIR OAKS AVE STE 230",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052663",
            "telephone_number": "626-469-2939",
            "fax_number": "626-469-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAHER SAIFULLAH MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "SAIFULLAH",
        "authorized_official_first_name": "TAHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-524-1041",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.