Organization Active NPI

Rambod Amani Yazdi MD Corp

  • Endocrinology, Diabetes & Metabolism Physician
  • San Dimas, CA
National Provider Identifier
1720164551
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
A70521
Legal business name
RAMBOD AMANI YAZDI MD CORP
Practice address
1330 W Covina Blvd
Suite206
San Dimas, CA 91773-3200
Phone
(909) 267-9138
Fax
(909) 267-9566
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Authorized official

Name
Mr. Rambod Amani Yazdi, MD
Title
Physician
Phone
(909) 267-9138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X A70521 Primary

Addresses

Primary practice location

1330 W Covina Blvd
Suite206
San Dimas, CA 91773-3200

Mailing address

1330 W Covina Blvd
Suite 206
San Dimas, CA 91773-3200
Phone (909) 267-9138

Other identifiers 1

IdentifierTypeStateIssuer
00A705210MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081203000657 CA Part B Supplier - Clinic/Group Practice 6103987581 Receives reassigned benefits from 1 practitioner
Practice locations: Covina, CA; Baldwin Park, CA; West Covina, CA; San Dimas, CA; Glendora, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2042817Rambod Amani-Yazdi MD1330 W Covina Blvd Ste 206, San Dimas, CA 91773Certificate of waiverJun 19, 2028

National Provider Directory

National Provider Directory

Locations

1330 W Covina Blvd
#2
San Dimas, CA 91773

1330 W Covina Blvd
Ste 206
San Dimas, CA 91773
Phone (909) 267-9138

Practitioners & affiliated clinicians

Practitioners 2

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": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360713600000",
    "number": "1720164551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD",
            "address_2": "SUITE 206",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "909-267-9138",
            "fax_number": "909-267-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 W COVINA BLVD",
            "address_2": "SUITE206",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917733200",
            "telephone_number": "909-267-9138",
            "fax_number": "909-267-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAMBOD AMANI YAZDI MD CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-02-13",
        "status": "A",
        "authorized_official_last_name": "AMANI YAZDI",
        "authorized_official_first_name": "RAMBOD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "909-267-9138",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": "A70521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A705210",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.