Individual provider Active NPI

Amir Rahnavard, D.O.

  • Internal Medicine Physician
  • Corona, CA
National Provider Identifier
1669755153
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
UO2771 Issued in FL
Practice address
1451 Rimpau Ave Ste 213
Corona, CA 92879-7522
Phone
(951) 268-6272
NPI assigned
Sep 21, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20A15779 CA
Internal Medicine Physician 207R00000X UO2771 FL Primary

Addresses

Primary practice location

1451 Rimpau Ave Ste 213
Corona, CA 92879-7522

Mailing address

80545 US Highway 111
Indio, CA 92201-8367
Phone (760) 347-9221

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
I20180802001247 CA Practitioner - Internal Medicine 8123376407 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vital Medical Group IncGroup PAC ID 5597106930, 8 clinicians

Practice addresses (Care Compare)

1314 W Glenoaks Blvd
Suite 205
Glendale, CA 91201-4890
Phone (818) 396-5158

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A15779CAMDInternal Medicine Physician
UO2771FLMDInternal Medicine Physician

Practice roles (6 of 7)

OrganizationSpecialtyStatusNew patients
Vital Medical Group, Inc Single Specialty CurrentSince May 1, 2024 Accepting new patients
Kolli Medical Corporation Single Specialty CurrentSince Jul 1, 2018 Accepting new patients
Remedial Patients Care Inc Single Specialty CurrentSince Sep 10, 2023 Accepting new patients
Hemchand Kolli, MD Inc Single Specialty CurrentSince Mar 21, 2020 Accepting new patients
Ac and CS Single Specialty PastSince May 1, 2024 Accepting new patients
Novak Urgent Care Inc Single Specialty Past Accepting new patients

Locations

801 E Birch St
Ste 2
Calexico, CA 92231
Phone (562) 273-5572

1451 Rimpau Ave
Ste 213
Corona, CA 92879
Phone (951) 268-6272

1314 W Glenoaks Blvd
Ste 205
Glendale, CA 91201
Phone (818) 396-5158

1278 E Latham Ave
Hemet, CA 92543
Phone (951) 925-6625

1600 E Florida Ave
Ste 103
Hemet, CA 92544
Phone (951) 925-6625

1215 N Wabash Ave
Redlands, CA 92374
Phone (909) 794-0200

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

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": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1669755153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80545 US HIGHWAY 111",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922018367",
            "telephone_number": "760-347-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 RIMPAU AVE STE 213",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928797522",
            "telephone_number": "951-268-6272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHNAVARD",
        "first_name": "AMIR",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-21",
        "last_updated": "2023-10-05",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A15779",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO2771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.