| Samina Habib Taha, MD | |
|
24342 Baxter Dr, Malibu, CA 90265-4742 | |
| (310) 804-4013 | |
| Not Available |
| Full Name | Samina Habib Taha |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 24342 Baxter Dr, Malibu, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073510533 | NPI | - | NPPES |
| 200200291 | Other | NC | NC LICENSE # |
| C54837 | Other | CA | CA LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 200200291 (North Carolina) | Secondary |
| 208000000X | Pediatrics | C54837 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Entity Name | Hankyu Chung Md Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780793497 PECOS PAC ID: 1557447919 Enrollment ID: O20080325000639 |
| Entity Name | Inspire Medical Group Of California Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700583440 PECOS PAC ID: 2668847732 Enrollment ID: O20230404001599 |
| Mailing Address | Practice Location Address |
|---|---|
| Samina Habib Taha, MD 24342 Baxter Dr, Malibu, CA 90265-4742 Ph: (310) 804-4013 | Samina Habib Taha, MD 24342 Baxter Dr, Malibu, CA 90265-4742 Ph: (310) 804-4013 |
Ms. Lucy Kaiser Larson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 24255 Pacific Coast Hwy, Pepperdine Student Health Center, Malibu, CA 90263 Phone: 310-506-4316 Fax: 310-506-4588 | |
Dr. Carol Elizabeth Nicholson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 6461 Zuma View Pl, #149, Malibu, CA 90265 Phone: 310-457-5660 |