Individual provider Active NPI

Tamseela T Awan, M.D.

  • Internal Medicine Physician
  • Patton, CA
National Provider Identifier
1720059413
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
C51379 Issued in CA
Practice address
3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone
(909) 425-7000
Fax
(909) 886-1798
NPI assigned
Jan 30, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

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
I20040917001105 CA Practitioner - Internal Medicine 4284602236 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C51379CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of State Hospitals Current Accepting new patients
Department of State Hospitals CurrentSince Sep 14, 2015 Accepting new patients
Department of State Hospitals CurrentSince Sep 14, 2015 Accepting new patients
Bullhead City Hospital Corporation Past Accepting new patients

Locations

3102 E Highland Ave
Ofc
Patton, CA 92369
Phone (909) 425-7000

3102 E Highland Ave
Patton, CA 92369
Phone (909) 425-7000

1215 O St
#3
Sacramento, CA 95814
Phone (916) 651-2805

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X C51379 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369

Mailing address

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369
Phone (909) 425-7000

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
00C513790MedicaidCA

Other names 1

NPPES NPI Registry
  • Tamseela Bashir Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 21, 2015.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1720059413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7000",
            "fax_number": "909-886-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7000",
            "fax_number": "909-886-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AWAN",
        "first_name": "TAMSEELA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-30",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C51379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C513790",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMSEELA",
            "last_name": "BASHIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Patton, CA

Sources for this page

Verify at the official NPI Registry.