Organization Active NPI

Farah a Ameeri D O Inc

  • Family Medicine Physician
  • Chino, CA
National Provider Identifier
1679591598
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7860 Issued in CA
Legal business name
FARAH A AMEERI D O INC
Practice address
13768 Roswell Ave
Suite 115
Chino, CA 91710-1401
Phone
(909) 364-0060
Fax
(909) 364-1126
NPI assigned
Jul 18, 2006
Last updated
Jun 21, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Farah A Ameeri, D.O.NPI 1023054699
Title
Owner
Phone
(909) 364-0600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7860 CA Primary

Addresses

Primary practice location

13768 Roswell Ave
Suite 115
Chino, CA 91710-1401

Mailing address

13768 Roswell Ave
Suite 115
Chino, CA 91710-1401
Phone (909) 364-0060

Other identifiers 2

IdentifierTypeStateIssuer
10940264OtherCACAQH
20A7860OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060801000416 CA Part B Supplier - Clinic/Group Practice 5597778969 Receives reassigned benefits from 1 practitioner
Practice locations: Chino, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1679591598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13768 ROSWELL AVE",
            "address_2": "SUITE 115",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101401",
            "telephone_number": "909-364-0060",
            "fax_number": "909-364-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13768 ROSWELL AVE",
            "address_2": "SUITE 115",
            "city": "CHINO",
            "state": "CA",
            "postal_code": "917101401",
            "telephone_number": "909-364-0060",
            "fax_number": "909-364-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARAH A AMEERI D O INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "AMEERI",
        "authorized_official_first_name": "FARAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-364-0600",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10940264",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20A7860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.