DIBA IZADYAR (NPI# 1710520671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710520671 |
| Entity Type | Individual |
| Full Name | DIBA IZADYAR |
| Credential | PA-C |
| Practice Address |
4617 Temescal Canyon Rd Apt 208 Corona CA 92883-4680 |
| Mailing Address |
Po Box 500063 San Diego CA 92150-0063 |
| Practice Telephone | 6089574492 |
| Mailing Telephone | 6089574492 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2019-10-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 57199 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4617 TEMESCAL CANYON RD APT 208 |
| City | CORONA |
| State | CA |
| Zip Code | 92883-4680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710496815 | Onyinye Yvonne Johnson | Nurse Practitioner | 27223 Lasso Way, Corona, CA 92883 | 2017-09-21 |
| 1215376850 | Jennifer Carol Bard | Speech-Language Pathologist | 4194 Floyd Drive, Corona, CA 92883 | 2013-06-17 |
| 1023359619 | Richard Joon Kim | Pharmacist | 4315 Driving Range Rd, Corona, CA 92883 | 2013-03-07 |
| 1740590330 | Kim-thoa Thi Vu | Pharmacist | 2243 Eagle Glen Parkway, Corona, CA 92883 | 2010-10-15 |
| 1114232154 | Always 'tfy' Hospice, Inc. | Hospice Care, Community Based | 9064 Pulsar Court, Ste E, Corona, CA 92883 | 2010-08-14 |
| 1952553844 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 11950 Depalma Rd, Corona, CA 92883 | 2008-10-22 |
| 1497979280 | Sang C Paik Dds | Dentist | 3811 Bedford Canyon Rd, Suite 105, Corona, CA 92883 | 2007-04-12 |
| 1285615864 | Mallory Leon | Family Medicine | 25085 Pacific Crest Street, Corona, CA 92883 | 2005-11-09 |
| 1326038993 | Chan Woo Lee | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2005-10-25 |
| 1659575736 | Optique Optometry, A Professional Corporation | Optometrist | 2790 Cabot Drive, Suite 135, Corona, CA 92883 | 2007-06-13 |
| Find all providers in zip 92883 | ||||
| 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 |
|---|---|---|---|---|
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1619534856 | Michael Christopher Charvis | Physician Assistant | 10411 Baldy Ct, Corona, CA 92883-9260 | 2019-05-23 |
| 1053882076 | Michael Eng | Physician Assistant | 760 Washburn Ave Ste 5, Corona, CA 92882-3303 | 2018-12-17 |
| 1740761154 | Rachael Renee Fulton | Physician Assistant | 651 Birchwood Ln, Corona, CA 92882-6127 | 2018-08-23 |
| 1972095693 | Eva Day | Physician Assistant | 1727 Gleason St, Corona, CA 92882-5634 | 2018-05-30 |
| 1477060499 | Shilpy Kanda | Physician Assistant | 2250 S Main St Ste 107, Corona, CA 92882 | 2017-12-29 |
| 1588090948 | Aprilyn Nadine Carl | Physician Assistant | 758 Highland View Dr, Corona, CA 92882-8679 | 2013-09-17 |
| 1003156449 | Ruoru Wong | Physician Assistant | 3717 111th St Apt 5e, Corona, NY 11368-2018 | 2013-02-21 |
| 1669718383 | Bushrah Patel | Physician Assistant | 915 Rimpau Ave, Apt 101, Corona, CA 92879-2354 | 2012-12-28 |
| 1053681114 | Anna Victoria Tang Tilt | Physician Assistant | 2097 Compton Ave Bldg 1 Ste 103, Corona, CA 92882 | 2012-01-06 |
| Find all providers in CORONA | ||||
Please comment or provide details below to improve the information on DIBA IZADYAR.
| 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.