Parkside Medical Group Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A33406 Issued in CA

Legal business name

PARKSIDE MEDICAL GROUP INC

Practice address

1310 San Bernardino Road
Suite 102
Upland, CA 91786-4985

Phone

(909) 608-2008

Fax

(909) 608-7705

NPI assigned

Mar 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mohsen Ibrahim Ali, M.D.NPI 1750359071

Title

Owner

Phone

(909) 608-2008

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohsen Ibrahim Ali, MD

  • Neurology Physician
  • San Dimas, CA
  • NPI 1750359071
  Medicare reassignment NPD Authorized official
• William S Baek, M.D..

  • Neurology Physician
  • Upland, CA
  • NPI 1326095977
  Medicare reassignment NPD

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1891935862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SAN BERNARDINO ROAD",
            "address_2": "SUITE 102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864985",
            "telephone_number": "909-608-2008",
            "fax_number": "909-608-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SAN BERNARDINO ROAD",
            "address_2": "SUITE 102",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864985",
            "telephone_number": "909-608-2008",
            "fax_number": "909-608-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "MOHSEN",
        "authorized_official_middle_name": "IBRAHIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-608-2008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A101427",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A33406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Bea Parker
• Travis Dejon Parker
• Kevin J Parkes, MD
• Parks & Powers Psychotherapy
• Shawntre Ann Parks Jr., MA
• Maribel Parra
• Sowrabh Kumar Paspulati Saibaba
• Andrea Paola Passalacqua, DO
• Bipin C Patadia, MD
• Aayesha Arun Patel, PA

• Neurology Physician in Upland, CA
• Providers in Upland, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.