Individual provider Active NPI

Raja Dhalla, MD

  • Orthopaedic Surgery Physician
  • Pomona, CA
National Provider Identifier
1730157876
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A73993 Issued in CA
Practice address
1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767-3031
Phone
(909) 623-8796
Fax
(909) 623-3076
NPI assigned
Mar 14, 2006
Last updated
Jan 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A73993 CA Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X A73993 CA

Addresses

Primary practice location

1866 N Orange Grove Ave
Ste 202
Pomona, CA 91767-3031

Mailing address

4343 Market St
Ste a
Riverside, CA 92501-3567
Phone (909) 398-1550

Other identifiers 1

IdentifierTypeStateIssuer
00A739930MedicaidCA

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
I20050505000289 CA Practitioner - Orthopedic SurgeryPractitioner - Sports MedicinePractitioner - Hand Surgery 4284674615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Hand Surgery, Sports Medicine
Education
Loma Linda University School of Medicine, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4343 Market St
A
Riverside, CA 92501-3567
Phone (951) 787-4880

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A73993CAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dhalla Orthopedic Center Inc. Orthopaedic Surgery CurrentSince Mar 1, 2006 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients
Dhalla Orthopedic Center Orthopaedic Surgery Past Accepting new patients

Locations

4343 Market St
Riverside, CA 92501
Phone (951) 787-4880

4343 Market St
Ste A
Riverside, CA 92501
Phone (951) 787-4880

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: rdhalla54701@direct.llu.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1730157876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 MARKET ST",
            "address_2": "STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013567",
            "telephone_number": "909-398-1550",
            "fax_number": "909-398-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 N ORANGE GROVE AVE",
            "address_2": "STE 202",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673031",
            "telephone_number": "909-623-8796",
            "fax_number": "909-623-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALLA",
        "first_name": "RAJA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A73993",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A73993",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A739930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.