Individual provider Active NPI

Mary Debra Saliba, M.D.

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1790882124
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G082103 Issued in CA
Practice address
2320 Glendon Avenue
Los Angeles, CA 90064-2204
Phone
(310) 470-6108
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G082103 CA Primary

Addresses

Primary practice location

2320 Glendon Avenue
Los Angeles, CA 90064-2204

Mailing address

1130 S Ridgeley Dr
Los Angeles, CA 90019-2528
Phone (310) 470-6108

Other names 1

  • Dr. Debra Saliba Professional name

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
G082103CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1790882124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S RIDGELEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900192528",
            "telephone_number": "310-470-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 GLENDON AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642204",
            "telephone_number": "310-470-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIBA",
        "first_name": "MARY",
        "middle_name": "DEBRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G082103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "SALIBA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.