Individual provider Active NPI

Mohammad Kaleem Uddin, MD

  • Neurological Surgery Physician
  • Wildomar, CA
National Provider Identifier
1962405142
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
A83767 Issued in CA
Practice address
36243 Inland Valley Dr
Ste 210
Wildomar, CA 92595-9549
Phone
(951) 677-2300
Fax
(951) 677-1033
NPI assigned
May 23, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X A83767 CA Primary

Addresses

Primary practice location

36243 Inland Valley Dr
Ste 210
Wildomar, CA 92595-9549

Mailing address

36243 Inland Valley Dr
Ste 210
Wildomar, CA 92595-9549
Phone (951) 677-2300

Other names 1

  • None None None Other name

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
I20040510001704 CA Practitioner - Neurology 2163411521 Practice locations: Fallbrook, CA; Murrieta, CA; West Covina, CA

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

24910 Las Brisas Rd
Suite 108
Murrieta, CA 92562-4010
Phone (951) 677-2300

577 E Elder St
Suite E
Fallbrook, CA 92028-3079
Phone (760) 728-8349

933 S Sunset Ave
Suite 306
West Covina, CA 91790-3410
Phone (626) 337-2265

Hospital & facility affiliations

  • Southwest Healthcare Rancho Springs Hospital Hospital, Murrieta, CA, CCN 050701

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Redlands Community Hospital Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Uhs Corona Inc Past Accepting new patients
State University of Iowa Past Accepting new patients
Universal Health Services of Rancho Springs Inc Past Accepting new patients
Midwest Associates in Neurology LTD Neurology Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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

Hospital & facility affiliations 1

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": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962405142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR",
            "address_2": "STE 210",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959549",
            "telephone_number": "951-677-2300",
            "fax_number": "951-677-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36243 INLAND VALLEY DR",
            "address_2": "STE 210",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925959549",
            "telephone_number": "951-677-2300",
            "fax_number": "951-677-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDDIN",
        "first_name": "MOHAMMAD",
        "middle_name": "KALEEM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A83767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NONE",
            "last_name": "NONE",
            "middle_name": "NONE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.