Faezeh Talebi Liasi, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A159670 Issued in CA

Practice address

1620 E 2ND St Ste N
Beaumont, CA 92223

Phone

(951) 845-6500

Fax

(866) 859-0338

NPI assigned

May 2, 2017

Last updated

Jul 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

University of Washington School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Csi Medical GroupGroup PAC ID 5890916845, 104 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Csi Medical Group

  • MOHS-Micrographic Surgery Physician
  • San Pedro, CA
  • NPI 1871909804

  Dermatology

  Medicare reassignment Care Compare group NPD
• K. D. Macknet, M.D., Inc.

  dba Loma Linda Dermatology Medical Group

  • Dermatology Physician
  • Loma Linda, CA
  • NPI 1083791644
  NPD
• Timothy F. Richardson, M.D., a Medical Corporation

  dba Mirage Dermatology Medical Associates, Inc.

  • Medical Specialty Clinic/Center
  • Palm Desert, CA
  • NPI 1346262375
  NPD

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1801322516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36867 COOK ST STE 101",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116064",
            "telephone_number": "760-341-1999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E 2ND ST STE N",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "92223",
            "telephone_number": "951-845-6500",
            "fax_number": "866-859-0338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 W Carson St # 400",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905022004",
            "country_code": "US",
            "telephone_number": "310-222-2401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36867 Cook St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Palm Desert",
            "state": "CA",
            "postal_code": "92211",
            "country_code": "US",
            "telephone_number": "760-341-1999",
            "fax_number": "760-341-1997",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25815 Barton Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "92354",
            "country_code": "US",
            "telephone_number": "909-796-0224",
            "fax_number": "909-796-0225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALEBI LIASI",
        "first_name": "FAEZEH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A159670",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "300671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah S Stewart
• Camille Marie Stone, CNM
• Mukunthan Subramani
• Eugenie C Sumarli, DDS
• Sun Medical Equipment Inc (Sun Medical Supplies)
• Talking Solutions Family Counseling Center Inc.
• Gurjit Kaur Talwar, FNP-BC
• Bianca Ayessa H Tan
• Dayanerrah Taoete
• Breana Tate

• Dermatology Physician in Beaumont, CA
• Providers in Beaumont, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.