MAHMOOD FATHOLLAZADEH (NPI# 1386711158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386711158 |
| Entity Type | Individual |
| Full Name | MAHMOOD FATHOLLAZADEH |
| Credential | PA |
| Practice Address |
9961 Sierra Ave Fontana CA 92335-6720 |
| Practice Telephone | 9094273910 |
| Mailing Telephone | 9094273910 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2008-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA12070 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9961 SIERRA AVE |
| City | FONTANA |
| State | CA |
| Zip Code | 92335-6720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578560199 | Barbara Ann Mahoney | Nurse Practitioner | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2005-06-29 |
| 1023629979 | Whitney Mah | Speech-Language Pathologist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-08-13 |
| 1083224166 | Jennifer Hull | Genetic Counselor, MS | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-08-04 |
| 1568081842 | Jorge Kareem Sierra | Radiologic Technologist | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-04-16 |
| 1821625963 | Syed Sajjad Sarwar Naqvi | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-26 |
| 1730716903 | Hannah Choi | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-26 |
| 1912534413 | Mia Raquel Montoya | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1093342461 | Jennica Kahkejian | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1881221299 | Youstina Youssef | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| 1790312015 | Sara Tong | Student in an Organized Health Care Education/Training Program | 9961 Sierra Ave, Fontana, CA 92335-6720 | 2020-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1790312791 | Trevor Nguyen | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd, Building A, Fontana, CA 92335 | 2020-03-27 |
| 1184251365 | Benjamin Chang | Student in an Organized Health Care Education/Training Program | 17234 Valley Blvd., Bldg. A, Fontana, CA 92335 | 2020-03-26 |
| 1407487309 | Perla Hernandez | Licensed Vocational Nurse | 14677 Merrill Aver, Fontana, CA 92335 | 2020-01-29 |
| 1013552660 | Valencia Malone | Licensed Vocational Nurse | 14677 Merrill, Fontana, CA 92335 | 2019-11-07 |
| 1831749779 | Daniel Eric Wright | Student in an Organized Health Care Education/Training Program | 14677 Merrell Ave., Fontana, CA 92335 | 2019-09-12 |
| 1962069815 | Melissa Rivera | Licensed Vocational Nurse | 15217 San Bernardino Ave., Fontana, CA 92335 | 2019-05-28 |
| 1275199770 | Jennifer Lynn Malone | Peer Specialist | 14677 Merrall Ave, Fontana, CA 92335 | 2019-05-10 |
| 1770147894 | Noelle Chong | Registered Nurse | 14677 Merill Ave, Fontana, CA 92335 | 2019-04-24 |
| 1992261929 | Destiny Alzate | Counselor | 1467 Merrill Ave, Fontana, CA 92335 | 2019-02-14 |
| Find all providers in zip 92335 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356968325 | Tracey Huddleston | Physician Assistant | 13676 Dodge Ct, Fontana, CA 92336-3405 | 2020-06-25 |
| 1114559176 | Theresa Nkechinyerem Okeke | Physician Assistant | 5931 Wilshire Dr, Fontana, CA 92336-5697 | 2020-02-07 |
| 1972018513 | Tanya Lumbangaol | Physician Assistant | 6768 Winter Night Ct, Fontana, CA 92336-1417 | 2017-12-05 |
| 1174046676 | Diana Jaqueline Romo | Physician Assistant | 6570 Kaiser Ave, Fontana, CA 92336-3260 | 2017-07-18 |
| 1417482761 | Jeffrey Lynn Cox | Physician Assistant | 10444 Live Oak Ave, Fontana, CA 92337-7219 | 2017-04-25 |
| 1811356439 | Khristine Marie Bueno | Physician Assistant | 16465 Sierra Lakes Pkwy Ste 100, Fontana, CA 92336-1242 | 2016-02-11 |
| 1407237498 | Natalie Kathleen Herrera | Physician Assistant | 16456 Sierra Lakes Pkwy, Suite 300, Fontana, CA 92336 | 2015-06-15 |
| 1619385309 | Daniel Loera | Physician Assistant | 17156 Manzanita Dr, Fontana, CA 92335-5851 | 2014-07-26 |
| 1396175758 | Martha C Ajca | Physician Assistant | 17051 Sierra Lakes Parkway, Suite 101, Fontana, CA 92336 | 2013-11-22 |
| 1053666297 | Vanessa M Michelena Basantes | Physician Assistant | 4904 Tahan Way, Fontana, CA 92336-0428 | 2012-07-13 |
| Find all providers in FONTANA | ||||
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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.