Active NPI
Sam Ahdab, M.D.
- Interventional Pain Medicine Physician
- West Covina, CA
National Provider Identifier
1992941397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- A126658
- Practice address
- 1433 W Merced Ave Ste 103
West Covina, CA 91790-3402 - Phone
- (626) 506-2648
- Fax
- (626) 898-9250
- NPI assigned
- Jan 6, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | 126658 | CA | |
| Pain Medicine Physician | 208VP0000X | 126658 | CA | |
| Interventional Pain Medicine Physician | 208VP0014X | A126658 | CA | Primary |
| Internal Medicine Physician | 207R00000X | 126658 | CA |
Addresses
Primary practice location
1433 W Merced Ave Ste 103
West Covina, CA 91790-3402
Mailing address
1433 W Merced Ave Ste 103
West Covina, CA 91790-3402
Phone (323) 217-2856
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140313002132 | CA | Practitioner - Pain Management | 2365606753 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Pain Management
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1433 W Merced Ave
West Covina, CA 91790-3402
Phone (626) 506-2648
Hospital & facility affiliations
- Emanate Health Inter-Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126658 | CA | MD | Hospice and Palliative Medicine (Internal Medicine) Physician |
| A126658 | CA | MD | Interventional Pain Medicine Physician |
Practice roles (1 of 2)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Dimas Community Hospital, Inc. | Past | Accepting new patients |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FIECAD/Endpoint/FIECAD
Organizations & group practices 2
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.
-
- Skilled Nursing Facility
- San Dimas, CA
- NPI 1568487619
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770163200000",
"number": "1992941397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1433 W MERCED AVE STE 103",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917903402",
"telephone_number": "323-217-2856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1433 W MERCED AVE STE 103",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917903402",
"telephone_number": "626-506-2648",
"fax_number": "626-898-9250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHDAB",
"first_name": "SAM",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-06",
"last_updated": "2026-02-04",
"certification_date": "2026-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0002X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": "CA",
"license": "126658",
"primary": false
},
{
"code": "208VP0000X",
"taxonomy_group": "",
"desc": "Pain Medicine, Pain Medicine",
"state": "CA",
"license": "126658",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "CA",
"license": "A126658",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "126658",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.