Individual provider Active NPI

Melvin Arthur Quan, MD

  • Family Medicine Physician
  • Riverside, CA
National Provider Identifier
1083760425
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A40166 Issued in CA
Practice address
4500 Riverwalk Pkwy
Student Health Service
Riverside, CA 92505-3344
Phone
(951) 785-2200
Fax
(951) 785-2263
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A40166 CA Primary

Addresses

Primary practice location

4500 Riverwalk Pkwy
Student Health Service
Riverside, CA 92505-3344

Mailing address

4500 Riverwalk Pkwy
Student Health Service
Riverside, CA 92505-3344
Phone (951) 785-2200

Other identifiers 1

IdentifierTypeStateIssuer
00A401660MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A40166CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Springs Medical Group, Inc. Family Medicine PastSince Aug 27, 2002 Accepting new patients
La Sierra University Health Clinic Past Accepting new patients
La Sierra University Student Health Services Past Accepting new patients

Organizations & group practices 3

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": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275609600000",
    "number": "1083760425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 RIVERWALK PKWY",
            "address_2": "STUDENT HEALTH SERVICE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053344",
            "telephone_number": "951-785-2200",
            "fax_number": "951-785-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 RIVERWALK PKWY",
            "address_2": "STUDENT HEALTH SERVICE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053344",
            "telephone_number": "951-785-2200",
            "fax_number": "951-785-2263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "MELVIN",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2010-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A40166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A401660",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.