Active NPI
Mona Tabib, MD
- Adult Medicine Physician
- Encino, CA
National Provider Identifier
1801990239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- A402870
- Practice address
- 16661 Ventura Blvd
Ste 211
Encino, CA 91436 - Phone
- (818) 789-7893
- Fax
- (818) 789-2346
- NPI assigned
- Sep 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | A402870 | CA | Primary |
Addresses
Primary practice location
16661 Ventura Blvd
Ste 211
Encino, CA 91436
Mailing address
4520 Caminito PL
Tarzana, CA 91356-4720
Phone (818) 789-7893
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A402870 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40287 | CA | MD | General Practice Dentistry |
| A402870 | CA | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1801990239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4520 CAMINITO PL",
"city": "TARZANA",
"state": "CA",
"postal_code": "913564720",
"telephone_number": "818-789-7893",
"fax_number": "818-789-2346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16661 VENTURA BLVD",
"address_2": "STE 211",
"city": "ENCINO",
"state": "CA",
"postal_code": "91436",
"telephone_number": "818-789-7893",
"fax_number": "818-789-2346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABIB",
"first_name": "MONA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "CA",
"license": "A402870",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A402870",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.