Individual provider Active NPI

Hedyeh Mohajerin Golshan, M.D.

  • Internal Medicine Physician
  • Rialto, CA
National Provider Identifier
1174582688
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A75923 Issued in CA
Practice address
1850 N Riverside Ave
Suite 230
Rialto, CA 92376-8071
Phone
(909) 875-1199
Fax
(909) 875-1166
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A75923 CA Primary

Addresses

Primary practice location

1850 N Riverside Ave
Suite 230
Rialto, CA 92376-8071

Mailing address

1850 N Riverside Ave
Suite 230
Rialto, CA 92376-8071
Phone (909) 875-1199

Other identifiers 1

IdentifierTypeStateIssuer
00A759230MedicaidCA

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
I20081118000353 CA Practitioner - Internal Medicine 8628138815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1850 N Riverside Ave
Suite 230
Rialto, CA 92376-8082
Phone (909) 875-1199

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A75923CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hedyeh M Golshan MD and Associates Inc Internal Medicine CurrentSince Dec 1, 2007 Accepting new patients
San Antonio Regional Hospital Past Accepting new patients
Community Hospital of San Bernardino Past Accepting new patients
Dignity Health Past Accepting new patients
United Family Care Internal Medicine Past Accepting new patients
Pinnacle Medical Group, Inc. Internal Medicine Past Accepting new patients

Locations

1850 N Riverside Ave
Ste 230
Rialto, CA 92376
Phone (909) 821-0810

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1174582688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 N RIVERSIDE AVE",
            "address_2": "SUITE 230",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768071",
            "telephone_number": "909-875-1199",
            "fax_number": "909-875-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 N RIVERSIDE AVE",
            "address_2": "SUITE 230",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768071",
            "telephone_number": "909-875-1199",
            "fax_number": "909-875-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLSHAN",
        "first_name": "HEDYEH",
        "middle_name": "MOHAJERIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A75923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A759230",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

Verify at the official NPI Registry.