Individual provider Active NPI

Mohsen I Mabudian, M.D.

  • Allergy & Immunology Physician
  • Redlands, CA
National Provider Identifier
1629022819
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
C51804 Issued in CA
Practice address
2 W Fern Ave
Redlands, CA 92373-5916
Phone
(909) 793-3311
Fax
(909) 796-4158
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X C51804 CA Primary

Addresses

Primary practice location

2 W Fern Ave
Redlands, CA 92373-5916

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 793-3311

Other identifiers 1

IdentifierTypeStateIssuer
00C518040MedicaidCA

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
I20050422000741 CA Practitioner - Allergy/Immunology 1557273141 Reassigns benefits to 1 organization
Practice locations: Newport Beach, CA; Redlands, CA

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Oso Specialty Infusion IncGroup PAC ID 3274894720, 10 clinicians

Practice addresses (Care Compare)

1210 Indiana CT
Redlands, CA 92374-2896
Phone (909) 999-8548

17175 Gillette Ave
Suite B
Irvine, CA 92614-5602
Phone (949) 660-7126

320 Superior Ave
Suite 190
Newport Beach, CA 92663-2782
Phone (909) 998-8548

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C51804CAMDAllergy & Immunology Physician
14465RLAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
House Physician Partners, PC Past Accepting new patients
Oso Home Care, Inc. PastSince Mar 20, 2018 Accepting new patients
Van Meter MD & Associates Past Accepting new patients
Keith Van Meter & Associates Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mmabudian11184@epiclp.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629022819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-793-3311",
            "fax_number": "909-796-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W FERN AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923735916",
            "telephone_number": "909-793-3311",
            "fax_number": "909-796-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABUDIAN",
        "first_name": "MOHSEN",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "C51804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C518040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.