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TIN MOE SAN
NPI 1124362546
Pediatrics in Los Angeles, CA

Active since November 26, 2012PECOS Enrolled
5255 W SUNSET BLVD, LOS ANGELES, CA 90027(323) 463-7262 Get Directions Write a Review

NPPES record last updated: December 16, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Tin Moe San NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIN MOE SAN (NPI 1124362546) is an individual pediatrics provider in Los Angeles, California, licensed in California (A.124282) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124362546
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameTIN MOE SAN
Location Address5255 W SUNSET BLVDLos Angeles, CA 90027-5716
Mailing Address5255 W Sunset BlvdLos Angeles, CA 90027-5716 · (323) 463-7262
Phone(323) 463-7262
Sole ProprietorNo
Enumeration DateNovember 26, 2012
Last NPPES UpdateDecember 16, 2013
✔ NPI 1124362546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A.124282
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
5255 W SUNSET BLVD, Los Angeles, CA 90027
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tin Moe San is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Tin San reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

County Of Riverside
46 mi
Community/Behavioral Health
2813 S MAIN ST FL 2
Corona, CA 92882
  • Reassigned Medicare billing, California enrollment
  • 336 clinicians in this Medicare group
NPI 1205090453 (951) 738-2400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 90027 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$96.36 typical visit price
range $62.96 – $187.60
Typical copayment $24.09 (range $15.74 – $46.90)
Most-billed visit code 99203
Established Patient
$109.96 typical visit price
range $20.84 – $153.61
Typical copayment $27.49 (range $5.21 – $38.40)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YOSI PAYAM BEHROOZAN DDS INC.
Dentist
5255 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 463-7252
DR. EHTERAM BENJI BEHROOZAN
Dentist
5255 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 463-7252
BENJAMIN BEHROOZAN MD INC
Family Medicine (Hospice and Palliative Medicine)
5255 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 463-7262
E. BENJI BEHROOZAN DDS INC.
Dentist
5255 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 463-7252
GRACE LEE FNP
Nurse Practitioner (Family)
5255 W SUNSET BLVD
LOS ANGELES, CA 90027
Los Angeles County (323) 463-7262

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tin San's NPI number?

The NPI number for Tin San is 1124362546. It was assigned to this individual provider in the NPPES registry on November 26, 2012.

Where is Tin San located?

Tin San practices at 5255 W Sunset Blvd, Los Angeles, CA 90027. The listed phone number is (323) 463-7262.

What is Tin San's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Tin San enrolled in Medicare?

Yes. Tin San is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tin San's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tin San reassigns Medicare benefits to County Of Riverside (Corona, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tin San's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Tin San was last updated on December 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.