MIKIO TACHIBANA, M.D.
NPI 1265627731
Internal Medicine in Fountain Valley, CA
About Mikio Tachibana, M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MIKIO TACHIBANA, M.D. (NPI 1265627731) is a healthcare organization registered as an internal medicine in Fountain Valley, California and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through November 18, 2027 and lists Mikio Tachibana, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mikio Tachibana, M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Mikio Tachibana, M.D., which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D0899364
Mikio Tachibana MD · Fountain Valley, CAFrequently 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 Mikio Tachibana, M.D., Inc's NPI number?
The NPI number for Mikio Tachibana, M.D., Inc is 1265627731. It was assigned to this organization in the NPPES registry on September 7, 2007. The provider is also known as Mikio Tachibana, M.D..
Where is Mikio Tachibana, M.D., Inc located?
Mikio Tachibana, M.D., Inc is located at 11100 Warner Ave Suite 154, Fountain Valley, CA 92708. The listed phone number is (714) 966-2800.
What is Mikio Tachibana, M.D., Inc's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Mikio Tachibana, M.D., Inc enrolled in Medicare?
Yes. Mikio Tachibana, M.D., Inc is registered in the Medicare PECOS enrollment system.
When is Mikio Tachibana, M.D., Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (California, Clinic/Group Practice) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Mikio Tachibana, M.D., Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Mikio Tachibana, M.D., Inc. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mikio Tachibana, M.D., Inc hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D0899364) is associated with this NPI, valid through November 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Mikio Tachibana, M.D., Inc was last updated on September 7, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.
# Mikio Tachibana, M.d. · NPI 1265627731
Internal Medicine organization in Fountain Valley, California. Organization record, active in the CMS NPPES registry since September 7, 2007.
## Identity
- **NPI:** 1265627731 (Entity type: Organization)
- **Enumerated:** September 7, 2007
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Legal business name:** Mikio Tachibana, M.d., Inc
- **Organization subpart:** No
- **Authorized official:** Mikio Tachibana, PRESIDENT
## Practice location
- **Address:** 11100 WARNER AVE, SUITE 154, Fountain Valley, CA 92708-7506
- **Phone:** (714) 966-2800 · **Fax:** (714) 966-0421
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Non-DME Part B, California, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (Internal Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 7, 2007
- **Other identifiers:** Medicare UPIN A27781 (CA); Medicaid 00A354330 (CA)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1265627731) · Data from the CMS NPPES public registry.