Organization Active NPI

Southern California Liver Centers Inc

  • Hepatology Physician
  • Coronado, CA
National Provider Identifier
1871633099
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hepatology PhysicianTaxonomy code 207RI0008X
License
A54452 Issued in CA
Legal business name
SOUTHERN CALIFORNIA LIVER CENTERS INC
Practice address
131 Orange Ave Ste 101
Coronado, CA 92118-1408
Phone
(619) 522-0399
NPI assigned
Feb 7, 2007
Last updated
Oct 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Authorized official

Name
Dr. Tarek I. HassaneinNPI 1801854450
Title
Owner/President
Phone
(619) 990-1698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU
Hepatology Physician 207RI0008X A54452 CA Primary

Addresses

Primary practice location

131 Orange Ave Ste 101
Coronado, CA 92118-1408

Mailing address

PO Box 181770
Coronado, CA 92178-1770
Phone (619) 964-9649

Other identifiers 1

IdentifierTypeStateIssuer
00A544520MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041112001199 CA Part B Supplier - Clinic/Group Practice 3173584604 Receives reassigned benefits from 9 practitioners
Practice locations: Coronado, CA; El Cajon, CA; Palm Springs, CA; Riverside, CA; San Clemente, CA; Chula Vista, CA

National Provider Directory

National Provider Directory

Locations

256 Landis Ave
Ste 204
Chula Vista, CA 91910
Phone (619) 427-0665

303 H St
Ste 103
Chula Vista, CA 91910

230 Prospect Pl
#220
Coronado, CA 92118
Phone (619) 435-1138

463 N Magnolia Ave
Ste A
El Cajon, CA 92020

1180 N Indian Canyon Dr
Ste 304W
Palm Springs, CA 92262
Phone 6195220399501

4000 14th St
Ste 405
Riverside, CA 92501
Phone 6195220399501

6216 Brockton Ave
Ste 212
Riverside, CA 92506
Phone 6195220399412

675 Camino de los Mares
Ste 210
San Clemente, CA 92673
Phone (949) 496-6002

675 Camino de los Mares
Ste 301
San Clemente, CA 92673
Phone (619) 990-1698

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760400000000",
    "number": "1871633099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 181770",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921781770",
            "telephone_number": "619-964-9649",
            "fax_number": "619-996-2014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 ORANGE AVE STE 101",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181408",
            "telephone_number": "619-522-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CALIFORNIA LIVER CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A",
        "authorized_official_last_name": "HASSANEIN",
        "authorized_official_first_name": "TAREK",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "619-990-1698",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "CA",
            "license": "A54452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A544520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coronado, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.