Mariam S. Moghadam, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A86456 Issued in CA

Practice address

1181 N Mount Vernon Ave
Colton, CA 92324-2574

Phone

(909) 498-2356

Fax

(877) 824-9080

NPI assigned

Aug 14, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: mariam.moghadam@398008301912068.direct.elationemr.com

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396758942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 OCEANGATE",
            "address_2": "SUITE 100",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024317",
            "telephone_number": "909-498-2356",
            "fax_number": "877-824-9080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 N MOUNT VERNON AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923242574",
            "telephone_number": "909-498-2356",
            "fax_number": "877-824-9080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOGHADAM",
        "first_name": "MARIAM",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A86456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-COLTON",
            "identifier": "P01288539/DU5182",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-RIALTO",
            "identifier": "P01288539/DU4034",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Narges Moaddel, MD
• Mobile Care Services, Inc
• Mobility Solutions Inc
• Rebecca Lynn Mobley, R.N.
• Caleb Moering
• Vijay Anthony Mohamed, DDS
• Niki Mohammadi
• Mehnaaz Mohammed, MD
• Sumayya Mohammed
• Nancy Moharram, PHYSICIAN ASSISTANT

• Family Medicine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.