Individual provider Active NPI

Irene Bielawiec Houari, MD

  • Surgery Physician
  • Upland, CA
National Provider Identifier
1104060466
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A117875 Issued in CA
Practice address
901 San Bernardino Rd Suite 301
Upland, CA 91786
Phone
(909) 946-6221
Fax
(909) 949-3802
NPI assigned
Apr 29, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 25MA08805700 NJ
Surgery Physician 208600000X A117875 CA Primary

Addresses

Primary practice location

901 San Bernardino Rd Suite 301
Upland, CA 91786

Mailing address

PO Box 1792
Upland, CA 91785-1792

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120418000610 CA Practitioner - General SurgeryPractitioner - Colorectal Surgery (Proctology) 0345437265

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1104060466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1792",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917851792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD SUITE 301",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-946-6221",
            "fax_number": "909-949-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUARI",
        "first_name": "IRENE",
        "middle_name": "BIELAWIEC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-29",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MA08805700",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A117875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.