Individual provider Active NPI

Sultana Ikramullah, M.D.

  • Psychiatry Physician
  • Covina, CA
National Provider Identifier
1326065210
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A41576 Issued in CA
Practice address
500 W Badillo St
Covina, CA 91722-3762
Phone
(626) 859-2686
Fax
(626) 859-2685
NPI assigned
Jul 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A41576 CA Primary

Addresses

Primary practice location

500 W Badillo St
Covina, CA 91722-3762

Mailing address

500 W Badillo St
Covina, CA 91722-3762
Phone (626) 859-2686

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
I20080110000459 CA Practitioner - Psychiatry 7911950563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1963
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inland Psychiatric Medical Group IncGroup PAC ID 9436062312, 119 clinicians

Practice addresses (Care Compare)

500 W Badillo St
Covina, CA 91722-3762
Phone (626) 250-0936

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A41576CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Psychiatric Medical Group, Inc. Psychiatry CurrentSince Nov 30, 2021 Accepting new patients
Inland Psychiatric Medical Group, Inc. Psychiatry CurrentSince Nov 30, 2021 Accepting new patients
Forefront Telecare Inc Psychiatry Past Accepting new patients
Montclair Vida Health Clinic PC PastSince Aug 29, 2017 Accepting new patients

Locations

500 W Badillo St
Covina, CA 91722
Phone (626) 859-2686

1620 S Grand Ave
Glendora, CA 91740
Phone (626) 335-1919

24432 Muirlands Blvd
Ste 131
Lake Forest, CA 92630
Phone (714) 520-3000

1809 W Redlands Blvd
Redlands, CA 92373
Phone (909) 307-1320

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1326065210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223762",
            "telephone_number": "626-859-2686",
            "fax_number": "626-859-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223762",
            "telephone_number": "626-859-2686",
            "fax_number": "626-859-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKRAMULLAH",
        "first_name": "SULTANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A41576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.