Individual provider Active NPI

Hala Marie Azmi, PA-C, MMS

  • Medical Physician Assistant
  • Redlands, CA
National Provider Identifier
1710412499
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
54402 Issued in CA
Practice address
301 W Redlands Blvd
Redlands, CA 92373-4633
Phone
(909) 335-1900
NPI assigned
May 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA54402 CA
Medical Physician Assistant 363AM0700X 54402 CA Primary

Addresses

Primary practice location

301 W Redlands Blvd
Redlands, CA 92373-4633

Mailing address

9961 Sierra Ave
Fontana, CA 92335-6720
Phone (909) 427-5000

Other practice location 1

20849 Hillsdale Rd
Riverside, CA 92508-2529
Phone (951) 255-7229

Other names 1

  • Miss Hala Marie Ghaly Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181203000372 CA Practitioner - Physician Assistant 7315281300 Reassigns benefits to 3 organizations
I20221108002352 TX Practitioner - Physician Assistant 7315281300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Stanford University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mission Viejo Emergency Medical AssociatesGroup PAC ID 2163335241, 17 clinicians
Mission Viejo Emergency Medical Associates, Inc.Group PAC ID 7315090271, 28 clinicians

Practice addresses (Care Compare)

27700 Medical Ctr Rd
Mission Viejo, CA 92691-6426
Phone (949) 365-2202

31872 Coast Hwy
Laguna Beach, CA 92651-6773
Phone (949) 499-7193

Hospital & facility affiliations

  • Texas Health Presbyterian Hospital Kaufman Hospital, Kaufman, TX, CCN 450292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
54402CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Emergency Medicine CurrentSince Sep 19, 2018 Accepting new patients

Locations

1407 Foothill Blvd
La Verne, CA 91750
Phone (909) 596-3577

1295 Hamner Ave
Ste C
Norco, CA 92860
Phone (951) 272-6500

301 W Redlands Blvd
Redlands, CA 92373
Phone (909) 335-1900

33494 Oak Glen Rd
Yucaipa, CA 92399
Phone (909) 797-8900

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1710412499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720",
            "telephone_number": "909-427-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W REDLANDS BLVD",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734633",
            "telephone_number": "909-335-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20849 Hillsdale Rd",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925082529",
            "country_code": "US",
            "telephone_number": "951-255-7229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AZMI",
        "first_name": "HALA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-01",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA54402",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "54402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "HALA",
            "last_name": "GHALY",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.