Rodolfo T. Tabila, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A38544 Issued in CA

Practice address

1339 W Willow St
Long Beach, CA 90810-3116

Phone

(562) 492-6698

Fax

(562) 492-9553

NPI assigned

Feb 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

General Practice

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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 and National Provider Directory roles.

• First Integrated Care Medical Group Inc

  • Family Medicine Physician
  • Long Beach, CA
  • NPI 1720077852
  Medicare reassignment
• CHLB, LLC

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1215373626
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1962538181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1339 W WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908103116",
            "telephone_number": "562-492-6698",
            "fax_number": "562-492-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1339 W WILLOW ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908103116",
            "telephone_number": "562-492-6698",
            "fax_number": "562-492-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABILA",
        "first_name": "RODOLFO",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A38544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID NO",
            "identifier": "05D0865425",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID NO",
            "identifier": "05D0973914",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NO",
            "identifier": "A38544",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A385440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine K Ta, PHD
• Brian Tabak, M.D.
• Jenilyn Tabalon
• Kelie Wu Tabangay, LCSW
• Darian Tabares
• Jon Marion Tablang, LCSW
• Mary Kaye Taboada
• Tabrizi Brothers Chiropractic, Inc.
• Mohsen Tabrizi, MD
• Siavash Tabrizy, M.S., MFT., PH.D

• Family Medicine Physician in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; 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.