Ali Heidari, D.O.

Primary specialty

SpecialistTaxonomy code 174400000X

License

20A6946 Issued in CA

Practice address

843 E Foothill Blvd
Upland, CA 91786-4034

Phone

(909) 982-1002

NPI assigned

Aug 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Ali a Heidari, DO, a Professional Corporation

  • Plastic Surgery Physician
  • Upland, CA
  • NPI 1326224692
  Medicare reassignment Authorized official
• Premium Extremity Care, Inc.

  • Plastic Surgery Physician
  • Upland, CA
  • NPI 1427786367
  NPD Authorized official
• Merit Surgery Center, Inc

  • Ambulatory Surgical Clinic/Center
  • Upland, CA
  • NPI 1114103587
  Authorized official Same address or phone

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962516351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 ATLANTA AVE",
            "address_2": "G6",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925077417",
            "telephone_number": "951-682-8999",
            "fax_number": "951-682-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 E FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864034",
            "telephone_number": "909-982-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDARI",
        "first_name": "ALI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "20A6946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Health Innovation Ideas,LLC
• Health Service Alliance
• Healwise Healthcare LLC
• Hearing Professionals of America LLC
• Heartland Care, Inc.
• Chelsea Heller, MS, MS, PPS, LMFT
• Helpful Hand Assisted Living LLC
• Helping Hands Hospice Care, Inc.
• Martha Henao, MD
• Charles Henderson, PA-C

• Specialist in Upland, CA
• Providers in Upland, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.