Organization Active NPI

Dhalla Orthopedic Center Inc.

  • Orthopaedic Surgery Physician
  • Riverside, CA
National Provider Identifier
1740308683
Registry record updated Jun 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
DHALLA ORTHOPEDIC CENTER INC.
Practice address
4343 Market St
Riverside, CA 92501-3517
Phone
(951) 787-4880
Fax
(951) 787-8628
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2008

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

Authorized official

Name
Dr. Vir Prabhu Dhalla, MD
Title
President
Phone
(951) 787-4880

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X CA Primary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X

Addresses

Primary practice location

4343 Market St
Riverside, CA 92501-3517

Mailing address

4343 Market St
Riverside, CA 92501-3517
Phone (951) 787-4880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060117000280 CA Part B Supplier - Clinic/Group Practice 9335163443 Receives reassigned benefits from 4 practitioners
Practice locations: Riverside, CA

National Provider Directory

National Provider Directory

Locations

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

4343 Market St
Ste A
Riverside, CA 92501
Phone (951) 784-1671

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 4

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214524800000",
    "number": "1740308683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4343 MARKET ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013517",
            "telephone_number": "951-787-4880",
            "fax_number": "951-787-8628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 MARKET ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013517",
            "telephone_number": "951-787-4880",
            "fax_number": "951-787-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHALLA ORTHOPEDIC CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-06-27",
        "status": "A",
        "authorized_official_last_name": "DHALLA",
        "authorized_official_first_name": "VIR",
        "authorized_official_middle_name": "PRABHU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-787-4880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; 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.