Individual provider Active NPI

Fasiha Rashid Memon

  • Physician Assistant
  • Irvine, CA
National Provider Identifier
1033793104
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA59912 Issued in CA
Practice address
1400 Reynolds Ave Ste 100
Irvine, CA 92614-5562
Phone
(657) 900-4536
Fax
(657) 208-9732
NPI assigned
May 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA59912 CA Primary

Addresses

Primary practice location

1400 Reynolds Ave Ste 100
Irvine, CA 92614-5562

Mailing address

2621 S Bristol St Ste 202
Santa Ana, CA 92704-5718

Other practice location 1

710 N Euclid St Ste 210
Anaheim, CA 92801-4132
Phone (657) 900-4536

Other practice location 2

2621 S Bristol St Ste 202
Santa Ana, CA 92704-5718
Phone (657) 900-4536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241029000841 CA Practitioner - Physician Assistant 5092248112 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA59912CAMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1033793104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 S BRISTOL ST STE 202",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927045718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 REYNOLDS AVE STE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145562",
            "telephone_number": "657-900-4536",
            "fax_number": "657-208-9732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "710 N Euclid St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928014132",
            "country_code": "US",
            "telephone_number": "657-900-4536",
            "fax_number": "657-208-9732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2621 S Bristol St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Santa Ana",
            "state": "CA",
            "postal_code": "927045718",
            "country_code": "US",
            "telephone_number": "657-900-4536",
            "fax_number": "657-208-9732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEMON",
        "first_name": "FASIHA",
        "middle_name": "RASHID",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA59912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.