Active NPI
Ali Mohammad Movafagh, MD
- Family Medicine Physician
- Moreno Valley, CA
National Provider Identifier
1164587713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C42507
- Practice address
- 12712 Heacock St
Ste 1
Moreno Valley, CA 92553 - Phone
- (951) 485-0335
- Fax
- (951) 485-1514
- NPI assigned
- Dec 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C42507 | CA | Primary |
| Pediatrics Physician | 208000000X | C42507 | CA |
Addresses
Primary practice location
12712 Heacock St
Ste 1
Moreno Valley, CA 92553
Mailing address
12712 Heacock St
Ste 1
Moreno Valley, CA 92553
Phone (951) 485-0335
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00C425070 | Medicaid | CA |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C42507 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1164587713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12712 HEACOCK ST",
"address_2": "STE 1",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "92553",
"telephone_number": "951-485-0335",
"fax_number": "951-485-1514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12712 HEACOCK ST",
"address_2": "STE 1",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "92553",
"telephone_number": "951-485-0335",
"fax_number": "951-485-1514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOVAFAGH",
"first_name": "ALI",
"middle_name": "MOHAMMAD",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "C42507",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C42507",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00C425070",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
- Mountain Shadows Support Group, Inc
- Mountain Shadows Support Group, Inc
- Mountain Shadows Support Group, Inc.
- Mountain Shadows Support Group, Inc.
- Sharareh Movafagh-Tofigh, M.D., PH.D.
- Moval Healthcare Center Corporation
- Moval Physical Therapy
- Humberto Benjamin Moya, SOCIAL WORKER
- Yanina Linda Moya, P.A
- Cordialis Msora-Kasago, MA, RDN, DIPACLM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.