PARKSIDE MEDICAL GROUP INC (NPI# 1891935862) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891935862 |
| Entity Type | Organization |
| Organization Name | PARKSIDE MEDICAL GROUP INC |
| Practice Address |
1310 San Bernardino Road Suite 102 Upland CA 91786-4985 |
| Practice Telephone | 9096082008 |
| Practice Fax Number | 9096087705 |
| Mailing Telephone | 9096082008 |
| Mailing Fax Number | 9096087705 |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2015-06-18 |
| Authorized Official Name | DR. MOHSEN IBRAHIM ALI (OWNER) |
| Authorized Official Telephone | 9096082008 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | A101427 | CA | Allopathic & Osteopathic Physicians |
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
A33406 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1310 SAN BERNARDINO ROAD SUITE 102 |
| City | UPLAND |
| State | CA |
| Zip Code | 91786-4985 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093254 | California Clinics, Inc | Physical Medicine & Rehabilitation | 818 N Mountain Ave Ste 102, Upland, CA 91786 | 2019-09-23 |
| 1699231621 | Lynn Keitz | Nurse Practitioner | 360 East 7th Street, Suite D, Upland, CA 91786 | 2019-02-14 |
| 1003386608 | Devin A Lockett | Counselor | 916 N, Mountain Ave. Suite D-1, Upland, CA 91786 | 2018-11-27 |
| 1265900096 | Right Ride | Driver | 1023 West Arrow Hwy Apt A, Upland, CA 91786 | 2018-11-09 |
| 1689142069 | Mike Sedat Safi | Driver | 1023 W Arrow Hwy, Apt A, Upland, CA 91786 | 2018-11-05 |
| 1902373640 | Barsoum Dental | Dentist | 258 E. 9th Street, Upland, CA 91786 | 2018-10-31 |
| 1346736600 | Jennifer Lynn Henshaw | Counselor | Rosewood Counseling Center, 288 W 9th Street, Upland, CA 91786 | 2018-07-10 |
| 1972099521 | Sadeg Aldolaim | Nurse Practitioner | 2086 W Arrow Route, Apt 824, Upland, CA 91786 | 2018-07-06 |
| 1831607332 | Sandra Sun | Pharmacist | 1445 E. Foothill Blvd., Upland, CA 91786 | 2018-01-18 |
| 1841713625 | Dynamic Performance Physical Therapy Inc | Clinic/Center | 2377 W. Foothill Blvd, Ste 20, Upland, CA 91786 | 2017-07-24 |
| Find all providers in zip 91786 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| 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. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275586430 | Faisal M Qazi | Psychiatry & Neurology | 901 San Bernadino Rd Ste 102, Upland, CA 91786 | 2006-05-18 |
| 1386607950 | Chaparral Medical Group Inc | Psychiatry & Neurology | 630 North 13th Ave, Suite B, Upland, CA 91786-4956 | 2006-04-06 |
| 1023014628 | Calvin Randolph Stafford Jr. | Psychiatry & Neurology | One Medical Center Blvd, Suite 533, Upland, PA 19013-3902 | 2005-06-28 |
| 1326202748 | Bhupat H Desai Md Inc | Psychiatry & Neurology | 630 N 13th Ave, Suite B, Upland, CA 91786-4975 | 2008-07-15 |
| 1962677823 | Kesha Abena Wilford | Psychiatry & Neurology | One Medical Center Blvd, Suite 533, Upland, PA 19013-3902 | 2008-04-22 |
| 1851505432 | P. Perry Wich, M.d., Inc. | Psychiatry & Neurology | 630 N 13th Ave, Suite F, Upland, CA 91786-4975 | 2007-05-10 |
| 1992917108 | Jeffrey D Ries D O A Professional Corporation | Psychiatry & Neurology | 1310 San Bernardino Rd, Ste 101, Upland, CA 91786-4985 | 2007-05-03 |
| 1326185190 | Regina Torsney-durkin | Psychiatry & Neurology | One Medical Center Blvd, Suite 533, Upland, PA 19013-3902 | 2007-01-31 |
| 1649362633 | Bhupat H Desai | Psychiatry & Neurology | 630 N 13th Ave, Suite B, Upland, CA 91786-4975 | 2006-09-28 |
| 1043317217 | Peiruch Perry Wich | Psychiatry & Neurology | 630 N 13th Ave, Suite F, Upland, CA 91786-4975 | 2006-09-20 |
| Find all providers in UPLAND | ||||
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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.