Organization Active NPI

Bardia Sadr MD a Professional Corp

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1265976351
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BARDIA SADR MD A PROFESSIONAL CORP
Practice address
800 S Main St
Corona, CA 92882-3420
Phone
(951) 737-4343
NPI assigned
Dec 8, 2016
Organization subpart
Yes
Parent organization
BARDIA SADR MD A PROFESSIONAL CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Bardia Sadr, MDNPI 1912398785
Title
Owner
Phone
(949) 310-3701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

800 S Main St
Corona, CA 92882-3420

Mailing address

131 Carmine
Irvine, CA 92618-0878
Phone (949) 310-3701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170306001374 CA Part B Supplier - Clinic/Group Practice 9638453921 Receives reassigned benefits from 1 practitioner
Practice locations: Los Alamitos, CA

National Provider Directory

National Provider Directory
Part of
Bardia Sadr MD a Professional Corp

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1265976351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 CARMINE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926180878",
            "telephone_number": "949-310-3701",
            "fax_number": "866-440-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S MAIN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928823420",
            "telephone_number": "951-737-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARDIA SADR MD A PROFESSIONAL CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BARDIA SADR MD A PROFESSIONAL CORP",
        "enumeration_date": "2016-12-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SADR",
        "authorized_official_first_name": "BARDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-310-3701",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.