Individual provider Active NPI

Fadia Rafla Attia, MD

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1578626925
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A45954 Issued in CA
Practice address
1820 Fullerton Ave Ste 115
Corona, CA 92881-3160
Phone
(951) 734-3233
Fax
(951) 734-5284
NPI assigned
Dec 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A45954 CA Primary

Addresses

Primary practice location

1820 Fullerton Ave Ste 115
Corona, CA 92881-3160

Mailing address

1901 Town and Country Dr Ste 104
Norco, CA 92860-3611
Phone (951) 808-6240

Other identifiers 1

IdentifierTypeStateIssuer
1578626925MedicaidCA

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
I20100527000315 CA Practitioner - Internal Medicine 1153450291 Practice locations: Corona, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45954CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1578626925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 TOWN AND COUNTRY DR STE 104",
            "city": "NORCO",
            "state": "CA",
            "postal_code": "928603611",
            "telephone_number": "951-808-6240",
            "fax_number": "951-738-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 FULLERTON AVE STE 115",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813160",
            "telephone_number": "951-734-3233",
            "fax_number": "951-734-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTIA",
        "first_name": "FADIA",
        "middle_name": "RAFLA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A45954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578626925",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.