Individual provider Active NPI

Rabiah Brandes Fresco, MD

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1326734708
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
97799 Issued in SC
Practice address
1770 N Orange Grove Ave Ste 101
Pomona, CA 91767-3027
Phone
(909) 469-9494
Fax
(909) 469-2120
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 97799 SC Primary

Addresses

Primary practice location

1770 N Orange Grove Ave Ste 101
Pomona, CA 91767-3027

Mailing address

3940 W Pine Blvd Apt 212
Saint Louis, MO 63108-3288

Other practice location 1

1298 Woodruff Rd
Greenville, SC 29607-5754
Phone (864) 236-4700

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
I20260330002975 CA Practitioner - Family Practice 9436683208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Saint Louis University School of Medicine, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1601 Monte Vista Ave
Suite 260
Claremont, CA 91711-6604

PHR Group Provider Enrollment Unit
Pasadena, CA 91188-0001

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: rabiah.brandesfresco.p3@direct.parktreechc.nextgenshare.com

Organizations & group practices 1

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": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1326734708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 W PINE BLVD APT 212",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 N ORANGE GROVE AVE STE 101",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673027",
            "telephone_number": "909-469-9494",
            "fax_number": "909-469-2120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1298 Woodruff Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296075754",
            "country_code": "US",
            "telephone_number": "864-236-4700",
            "fax_number": "864-236-4701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRESCO",
        "first_name": "RABIAH",
        "middle_name": "BRANDES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "97799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.