Uzma Rifat Ali, MD
Individual provider Active NPI Specialist · Fontana, CA
NPI 1376629261 · NPPES record last updated Nov 29, 2021
Key facts
- NPI
- 1376629261
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- A56304 (CA)
- Practice address
- 16465 Sierra Lakes Pkwy
Suite 240
Fontana, CA 92336-1242 - Phone
- (909) 355-3100
- Fax
- (909) 355-3131
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070523000746 | CA | Practitioner - Pediatric Medicine | 7911004056 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A56304 | CA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Permanente Medical Group | Current | Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients | |
| Southern California Permanente Medical Group | Current |
Accepting new patients |
Locations
9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910
393 E Walnut St
Unit 3RD
Pasadena, CA 91188
Phone (626) 405-7914
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A56304 | CA | Yes |
Addresses
Primary practice location
16465 Sierra Lakes Pkwy
Suite 240
Fontana, CA 92336-1242
Mailing address
16465 Sierra Lakes Pkwy
Suite 240
Fontana, CA 92336-1242
Phone (909) 355-3100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A563040 | Medicaid | CA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Other providers in Fontana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.