Individual provider Active NPI

Ideen Tabatabai, MD

  • Pediatric Endocrinology Physician
  • Santa Barbara, CA
National Provider Identifier
1871156471
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
A204016 Issued in CA
Practice address
400 W Pueblo St
Santa Barbara, CA 93105-4353
Phone
(805) 682-7111
NPI assigned
Apr 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X A204016 CA Primary
Pediatrics Physician 208000000X DR.0069624 CO
Pediatrics Physician 208000000X A204016 CA

Addresses

Primary practice location

400 W Pueblo St
Santa Barbara, CA 93105-4353

Mailing address

PO Box 689
Santa Barbara, CA 93102-0689
Phone (805) 682-7111

Other practice location 1

11234 Anderson Street
GME Office Westerly Suite C
Loma Linda, CA 92354-2804
Phone (909) 558-4174

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://memorialcare.org/fhir/api/FHIR/R4/ Health Information Exchange (HIE) MemorialCare Medical Foundation

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
I20260105003326 CA Practitioner - Pediatric Medicine 2466834965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Oklahoma College of Medicine, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

17360 Brookhurst St
Fountain Valley, CA 92708-3720

1919 Mile High Stadium Cir
Apt 707
Denver, CO 80204-2757

PO Box
Suite 689
Santa Barbara, CA 93102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A204016CAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorialcare Medical Foundation Pediatrics CurrentSince Dec 24, 2025 Accepting new patients
Cottage Medical Foundation CurrentSince Dec 1, 2025 Accepting new patients
Cottage Clinical Associates Pediatrics PastSince Feb 1, 2023 Accepting new patients

Locations

722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300

17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592

2701 Atlantic Ave
Long Beach, CA 90806
Phone (562) 684-8096

2 James Way
Ste 112
Pismo Beach, CA 93449
Phone (805) 556-3037

5333 Hollister Ave
Ste 250
Santa Barbara, CA 93111
Phone (805) 879-4240

400 W Pueblo St
Santa Barbara, CA 93105
Phone (805) 569-7279

4360 E Main St
Ste B2A
Ventura, CA 93003
Phone (805) 879-4240

Organizations & group practices 3

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": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1871156471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931020689",
            "telephone_number": "805-682-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W PUEBLO ST",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931054353",
            "telephone_number": "805-682-7111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson Street",
            "address_2": "GME Office Westerly Suite C",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TABATABAI",
        "first_name": "IDEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "CA",
            "license": "A204016",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0069624",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A204016",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://memorialcare.org/fhir/api/FHIR/R4/",
            "affiliation": "Y",
            "endpointDescription": "MemorialCare FHIR Endpoint",
            "affiliationName": "MemorialCare Medical Foundation",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "FHIR",
            "address_1": "17360 Brookhurst St",
            "city": "Fountain Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "927083720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

Verify at the official NPI Registry.