Individual provider Active NPI

Amgad R. Elsibai, M.D.

  • Anesthesiology Physician
  • Tarzana, CA
National Provider Identifier
1790706646
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A52784 Issued in CA
Practice address
18321 Clark St
Tarzana, CA 91356-3501
Phone
(310) 471-5852
Fax
(310) 471-3958
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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 A52784 CA Primary

Addresses

Primary practice location

18321 Clark St
Tarzana, CA 91356-3501

Mailing address

11999 San Vicente Blvd
#440
Los Angeles, CA 90049-5131
Phone (310) 471-5852

Other identifiers 1

IdentifierTypeStateIssuer
00A527840MedicaidCA

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
I20081029000509 CA Practitioner - Anesthesiology 4981762358 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A52784CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Oct 18, 2025 Accepting new patients
County of Los Angeles CurrentSince Oct 18, 2025 Accepting new patients
Uscan Anesthesiology Medical Group, Inc. Anesthesiology Past Accepting new patients

Locations

1000 S Fremont Ave
Bldg A11
Alhambra, CA 91803
Phone (626) 457-4240

335 E Avenue I
Lancaster, CA 93535
Phone (661) 471-4000

1200 N State St
Ste 14
Los Angeles, CA 90089
Phone (213) 342-8762

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.

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1790706646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD",
            "address_2": "#440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495131",
            "telephone_number": "310-471-5852",
            "fax_number": "310-471-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18321 CLARK ST",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563501",
            "telephone_number": "310-471-5852",
            "fax_number": "310-471-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELSIBAI",
        "first_name": "AMGAD",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A52784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A527840",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.