Miriam Fahim

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

A193694 Issued in CA

Practice address

9850 Genesee Ave Ste 600
La Jolla, CA 92037-1207

Phone

(858) 554-7700

NPI assigned

Mar 24, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mfahim303633@direct.llu.edu

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.

• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935923

  CA, Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Scripps Health

  • Multi-Specialty Clinic/Center
  • La Jolla, CA
  • NPI 1275899072

  CA, Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Faculty Physicians and Surgeons of Llusm

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Apple Valley, CA
  • NPI 1205009917

  CA, Multi-Specialty

  Medicare reassignment NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1467274126
  Care Compare group NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1649547944
  Care Compare group NPD
• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704

  Multi-Specialty

  Care Compare group NPD
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • San Bernardino, CA
  • NPI 1013935915
  Care Compare group
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • Murrieta, CA
  • NPI 1164045522
  Care Compare group
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1235784166
  Care Compare group
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • Indio, CA
  • NPI 1386299204
  Care Compare group
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • Blythe, CA
  • NPI 1477212249
  Care Compare group
• Sac Health System

  • Federally Qualified Health Center (FQHC)
  • Murrieta, CA
  • NPI 1548028962
  Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Scripps Health

  • General Acute Care Hospital
  • La Jolla, CA
  • NPI 1841277704

  Hospital

  Care Compare affiliation

Specialty

Obstetrics/Gynecology

Education

Eastern Virginia Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sac Health System 222 clinicians

Scripps Health 1,450 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324

Procedures performed for Medicare patients

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1992332639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE STE 600",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371207",
            "telephone_number": "858-554-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHIM",
        "first_name": "MIRIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A193694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Eyler, PA
• Mona M. Ezzat, M.D.
• Kace A. Ezzet, M.D.
• Christina Faddoul-Lucero
• Tali Faggiano
• Marianne Fahmy, M.D.
• Arij Faksh, DO
• Monsita Josefa Faley, FNP
• Joshua Paul Fallentine, MD
• Lakeisha Nacoste Falwell, RN, BSN, NP

• All providers in La Jolla, CA
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.