Individual provider Active NPI

Darlene M Rae, M.D.

  • Family Medicine Physician
  • Fontana, CA
National Provider Identifier
1881640373
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A55358 Issued in CA
Practice address
16465 Sierra Lakes Pkwy Ste 115
Fontana, CA 92336-1242
Phone
(909) 823-8000
Fax
(909) 823-8088
NPI assigned
May 26, 2006
Last updated
May 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A55358 CA Primary

Addresses

Primary practice location

16465 Sierra Lakes Pkwy Ste 115
Fontana, CA 92336-1242

Mailing address

PO Box 10069
San Bernardino, CA 92423-0069
Phone (909) 335-4188

Other identifiers 1

IdentifierTypeStateIssuer
00A553580MedicaidCA

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
I20070327000618 CA Practitioner - Family PracticePractitioner - Emergency Medicine 2769586924 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55358CAMDProsthodontist
A55358CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaver Medical Group P C CurrentSince Aug 21, 2006 Accepting new patients
Beaver Medical Group P C Family Medicine CurrentSince Aug 21, 2006 Accepting new patients
Namita Mohideen MD Inc Past Accepting new patients

Locations

6109 W Ramsey St
Banning, CA 92220
Phone (909) 845-0313

81 Highland Springs Ave
Ste 200
Beaumont, CA 92223
Phone (909) 389-1302

2 W Fern Ave
Redlands, CA 92373
Phone (909) 335-4137

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1881640373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10069",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230069",
            "telephone_number": "909-335-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 115",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-823-8000",
            "fax_number": "909-823-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAE",
        "first_name": "DARLENE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A55358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A553580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.