Individual provider Active NPI

Haider Z Rizvi, MD

  • Emergency Medicine Physician
  • Chino, CA
National Provider Identifier
1255355186
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A54680 Issued in CA
Practice address
5451 Walnut Ave
Chino, CA 91710-2609
Phone
(909) 464-8666
Fax
(909) 464-8600
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X A54680 CA Primary

Addresses

Primary practice location

5451 Walnut Ave
Chino, CA 91710-2609

Mailing address

PO Box 660305
Arcadia, CA 91066-0305
Phone (626) 447-0296

Other identifiers 1

IdentifierTypeStateIssuer
A54680OtherCAMEDICAL LICENSE

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
I20090216000296 CA Practitioner - Emergency Medicine 7618032236 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54680CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chino Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Jul 1, 2012 Accepting new patients
Mountain View Emergency Physicians Medical Group, Inc. Emergency Medicine CurrentSince Oct 19, 2011 Accepting new patients
San Dimas Emergency Medical Associates Inc. Emergency Medicine CurrentSince May 1, 2011 Accepting new patients
Montclair Emergency Medical Associates Emergency Medicine CurrentSince Jul 1, 2011 Accepting new patients
Chino Emergency Medical Associates Emergency Medicine Past Accepting new patients

Locations

5451 Walnut Ave
Chino, CA 91710
Phone (909) 464-8600

5000 San Bernardino St
Montclair, CA 91763
Phone (909) 625-4111

1350 W Covina Blvd
San Dimas, CA 91773
Phone (909) 394-2745

999 San Bernardino Rd
Upland, CA 91786
Phone (909) 920-4841

Organizations & group practices 5

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1255355186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660305",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910660305",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 WALNUT AVE",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917102609",
            "telephone_number": "909-464-8666",
            "fax_number": "909-464-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZVI",
        "first_name": "HAIDER",
        "middle_name": "Z",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A54680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "A54680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

Verify at the official NPI Registry.