NPIMap

Individual provider Active NPI

Tarek R Nassif, MD

  • Family Medicine Physician
  • San Gabriel, CA
National Provider Identifier
1730124611
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A53919 Issued in CA
Practice address
416 W Las Tunas Dr
Suite #307
San Gabriel, CA 91776-1236
Phone
(626) 289-0130
Fax
(626) 289-0171
NPI assigned
Jun 17, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A53919 CA
Family Medicine Physician 207Q00000X A53919 CA Primary

Addresses

Primary practice location

416 W Las Tunas Dr
Suite #307
San Gabriel, CA 91776-1236

Mailing address

416 W Las Tunas Dr
Suite #307
San Gabriel, CA 91776-1236
Phone (626) 289-0130

Other identifiers 1

IdentifierTypeStateIssuer
00A539190MedicaidCA

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
I20050421000612 CA Practitioner - Emergency MedicinePractitioner - Family Practice 5597703330 Reassigns benefits to 2 organizations
Practice locations: San Gabriel, CA

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

416 W Las Tunas Dr
Suite 307
San Gabriel, CA 91776-1236

416 W Las Tunas Rd
Suite 307
San Gabriel, CA 91776
Phone (626) 289-0130

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53919CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Andy Shen, M.D., Inc. Emergency Medicine CurrentSince Apr 1, 2011 Accepting new patients
Healthcare Partners Affiliates Medical Group Family Medicine CurrentSince Apr 13, 2009 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Apr 13, 2009 Accepting new patients
Usc Arcadia Hospital Past Accepting new patients
Dignity Community Care Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Rancho Faculty Medical Associates, Inc. Past Accepting new patients
Alhambra Hospital Medical Center, LP Past Accepting new patients

Locations

100 S Raymond Ave
Alhambra, CA 91801
Phone (626) 457-7938

55 S Raymond Ave
Ste 200
Alhambra, CA 91801
Phone (626) 570-8005

450 E Huntington Dr
Arcadia, CA 91006
Phone (626) 254-2100

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

1025 W Olympic Blvd
Los Angeles, CA 90015
Phone (213) 623-2225

675 S Arroyo Pkwy
Pasadena, CA 91105
Phone (626) 585-4120

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Atherton Baptist HomesAlhambra, CA, CCN 555272 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2016
Mar 14, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 8

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": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1730124611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR",
            "address_2": "SUITE #307",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-289-0130",
            "fax_number": "626-289-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W LAS TUNAS DR",
            "address_2": "SUITE #307",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761236",
            "telephone_number": "626-289-0130",
            "fax_number": "626-289-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSIF",
        "first_name": "TAREK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A53919",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A53919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A539190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

Verify at the official NPI Registry.