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PARKSIDE MEDICAL GROUP INC NPI 1891935862


NPI Information

NPI: 1891935862
Provider Name: PARKSIDE MEDICAL GROUP INC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 05D1099304

Address:
1310 SAN BERNARDINO ROAD
SUITE 102
UPLAND, CA
ZIP 91786
Phone: (909) 608-2008
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PARKSIDE MEDICAL GROUP INC is a neurology psychiatry neurology in Upland, CA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. PARKSIDE MEDICAL GROUP INC NPI is 1891935862. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1310 SAN BERNARDINO ROAD
SUITE 102
UPLAND, CA
ZIP 91786-985
Phone: (909) 608-2008
Fax: (909) 608-7705

The provider's authorized official is Mohsen Ibrahim Ali .
The authorized official title is Owner and has the following contact phone number (909) 608-2008.

The CLIA number assigned to this NPI record is 05D1099304 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/3/2009 and was last updated on 6/18/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineA101427CALIFORNIANo
22084N0400XPsychiatry & NeurologyNeurologyA33406CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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