PEDIATRIC ADOLESCENT CLINIC (NPI# 1164859385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164859385 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ADOLESCENT CLINIC |
| Practice Address |
1214 Adriana Way Upland CA 91784-1742 |
| Mailing Address |
1214 Adriana Way Upland CA 91784 |
| Practice Telephone | 9099464155 |
| Practice Fax Number | 9099498836 |
| Mailing Telephone | 9099464155 |
| Mailing Fax Number | 9099498836 |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2013-10-02 |
| Authorized Official Name | DR. RAOUF AZIZ IBRAHIM I (PEDIATRICIAN) |
| Authorized Official Telephone | 9099464175 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
AFE33327 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1214 ADRIANA WAY |
| City | UPLAND |
| State | CA |
| Zip Code | 91784-1742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255762001 | Raouf A Ibrahim I | Pediatrics | 1214 Adriana Way, Upland, CA 91784-1742 | 2013-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811488265 | Garfield Beach Cvs, L.l.c | Durable Medical Equipment & Medical Supplies | 2121 W Baseline Rd, Upland, CA 91784 | 2018-05-22 |
| 1518490135 | Christopher Velasquez | Emergency Medicine | 481 Fremont St, Upland, CA 91784 | 2017-04-10 |
| 1558613240 | Yung Huang | Marriage & Family Therapist | 1550 Geryser St., Upland, CA 91784 | 2012-10-05 |
| 1508132051 | Bunsri Thanasophon | Orthopaedic Surgery | 285 East 24th Street, Upland, CA 91784 | 2012-03-29 |
| 1265742605 | Shahin Taheri | Pharmacist | 15222 Summit Ave, Fontana, CA 91784 | 2010-10-19 |
| 1093883886 | Asha Nayak Ubhayakar | Family Medicine | 1157 West 22nd Street, Upland, CA 91784 | 2006-12-01 |
| 1790385250 | David Christopher Sudyka | Counselor | 1106 W 22nd St, Upland, CA 91784 | 2020-10-26 |
| 1770786428 | Mahmoud Torabinejad | Dentist | 600 N Euclid Ave, #102, Upland, CA 91784 | 2007-06-08 |
| 1730532946 | Michael Cervantes | Dentist | 2523 Mountain Ln, Upland, CA 91784-1075 | 2016-07-22 |
| 1497099220 | Ellen Liu | Nurse Practitioner | 1307 Mallorca St, Upland, CA 91784-1090 | 2012-11-16 |
| Find all providers in zip 91784 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255762001 | Raouf A Ibrahim I | Pediatrics | 1214 Adriana Way, Upland, CA 91784-1742 | 2013-12-04 |
| 1811941057 | Pediatric Associates | Pediatrics | 30 Medical Center Blvd, Suite 103, Upland, PA 19013-3955 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154986107 | School Health Clinics of Santa Clara County | Pediatrics | 855 Lenzen Ave Rm 105, San Jose, CA 95126-2736 | 2019-05-06 |
| 1669927125 | Irvine Doctors of Kids and Teens | Pediatrics | 4950 Barranca Pkwy Ste 306, Irvine, CA 92604-4631 | 2016-08-24 |
| 1043673270 | Alexander S Golec | Pediatrics | 3333 California St Ste 245, San Francisco, CA 94118-6210 | 2016-04-04 |
| 1710360094 | Jennifer Johnson, M.d., A Professional Corporation | Pediatrics | 366 San Miguel Dr Ste 209, Newport Beach, CA 92660-7810 | 2015-07-03 |
| 1902290448 | Brittany Kathleen Badal | Pediatrics | 2330 Post St Ste 219, San Francisco, CA 94115-3465 | 2015-03-23 |
| 1750770608 | Ighia Aintablian Md A Professional Corporation | Pediatrics | 1510 S Central Ave Ste 450, Glendale, CA 91204-2510 | 2015-01-15 |
| 1184035032 | Carlos Beharie M.d. Medical Group, Inc. | Pediatrics | 4160 N. Maine Ave, Suite B1, B2, B3, Baldwin Park, CA 91706-3304 | 2014-05-14 |
| 1578804084 | Eleanor S. Blatt | Pediatrics | 212 20th St, Huntington Beach, CA 92648-3914 | 2013-03-07 |
| 1053676619 | Gladys Hope Dadivas Yerro | Pediatrics | 14555 Hamlin St Ste 108, Van Nuys, CA 91411-1617 | 2012-07-10 |
| 1730471699 | Ilana Katsnelson | Pediatrics | 901 Campus Dr Ste 210, Daly City, CA 94015-4930 | 2011-05-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.