Individual provider Active NPI

Sabiha F. Kanchwala, MD

  • Pediatrics Physician
  • Loma Linda, CA
National Provider Identifier
1972715183
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A121897 Issued in CA
Practice address
25845 Barton Rd
Loma Linda, CA 92354-3899
Phone
(909) 558-2828
NPI assigned
May 3, 2007
Last updated
Nov 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MT187354 PA
Pediatrics Physician 208000000X MA08472000 NJ
Pediatrics Physician 208000000X A121897 CA Primary

Addresses

Primary practice location

25845 Barton Rd
Loma Linda, CA 92354-3899

Mailing address

25845 Barton Rd
Loma Linda, CA 92354-3899
Phone (909) 558-2828

Other identifiers 2

IdentifierTypeStateIssuer
A121897OtherCACALIFORNIA MEDICAL BOARD
MA08472000OtherNJSTATE LICENSE

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
I20161209000169 CA Practitioner - Pediatric Medicine 2365505658 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121897CAMDSocial Worker
A121897CAMDPediatrics Physician
MA08472000NJMDPediatrics Physician
MT187354PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Sac Health System Current Accepting new patients
Sac Health System CurrentSince Nov 16, 2016 Accepting new patients
Sac Health System CurrentSince Nov 16, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Pediatrics CurrentSince Nov 16, 2016 Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
The Cooper Health System Past Accepting new patients
Loma Linda University Children's Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

7223 Church St
Ste C1
Highland, CA 92346
Phone (909) 425-3946

82934 Civic Center Dr
Indio, CA 92201
Phone (760) 477-0733

11370 Anderson St
Ste 1800
Loma Linda, CA 92354
Phone (909) 558-2154

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26780 Barton Rd
Redlands, CA 92373
Phone (909) 558-5174

1455 3rd Ave
Sn Bernrdno, CA 92408
Phone (909) 382-7146

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1972715183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543899",
            "telephone_number": "909-558-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25845 BARTON RD",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543899",
            "telephone_number": "909-558-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANCHWALA",
        "first_name": "SABIHA",
        "middle_name": "F.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT187354",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "MA08472000",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A121897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL BOARD",
            "identifier": "A121897",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MA08472000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.