Individual provider Active NPI

Mohan S. Sidhu, M.D.

  • Anesthesiology Physician
  • Long Beach, CA
National Provider Identifier
1760405583
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A031636 Issued in CA
Practice address
2801 Atlantic Ave
Long Beach, CA 90806-1701
Phone
(562) 933-2000
Fax
(562) 933-1245
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A031636 CA Primary

Addresses

Primary practice location

2801 Atlantic Ave
Long Beach, CA 90806-1701

Mailing address

PO Box 10429
Newport Beach, CA 92658-0429
Phone (949) 417-1812

Other identifiers 3

IdentifierTypeStateIssuer
00A316360385OtherCACALOPTIMA ID #
00A316360OtherCABLUE SHIELD ID #
00A316360MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A031636CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
California Anesthesia Associates Medical Group, Inc. Anesthesiology CurrentSince Sep 14, 1995 Accepting new patients

Locations

2880 Atlantic Ave
Ste 160
Long Beach, CA 90806
Phone (562) 453-3814

2801 Atlantic Ave
Long Beach, CA 90806
Phone (310) 933-2000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760405583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10429",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926580429",
            "telephone_number": "949-417-1812",
            "fax_number": "949-417-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ATLANTIC AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908061701",
            "telephone_number": "562-933-2000",
            "fax_number": "562-933-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "MOHAN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A031636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA ID #",
            "identifier": "00A316360385",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD ID #",
            "identifier": "00A316360",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A316360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.