Active NPI
Socal Academic Surgical Consultants Inc
- Surgery Physician
- Colton, CA
National Provider Identifier
1689550055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Legal business name
- SOCAL ACADEMIC SURGICAL CONSULTANTS INC
- Practice address
- 400 N Pepper Ave Ste 308
Colton, CA 92324-1801 - Phone
- (646) 770-4660
- NPI assigned
- Aug 12, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amir Ali Rahnemai Azar, MD
- Title
- President
- Phone
- (646) 770-4660
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | Primary |
Addresses
Primary practice location
400 N Pepper Ave Ste 308
Colton, CA 92324-1801
Mailing address
PO Box 123
Pasadena, CA 91102-0123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1805 Medical Center Dr
Sn Bernrdno, CA 92411
Phone (909) 877-6333
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1754956800000",
"number": "1689550055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 123",
"city": "PASADENA",
"state": "CA",
"postal_code": "911020123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N PEPPER AVE STE 308",
"city": "COLTON",
"state": "CA",
"postal_code": "923241801",
"telephone_number": "646-770-4660"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOCAL ACADEMIC SURGICAL CONSULTANTS INC",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-12",
"last_updated": "2025-08-12",
"certification_date": "2025-08-11",
"status": "A",
"authorized_official_last_name": "AZAR",
"authorized_official_first_name": "AMIR ALI",
"authorized_official_middle_name": "RAHNEMAI",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "646-770-4660",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Colton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2025; 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.