Provider Demographics
NPI:1174106231
Name:UPLAND RHEUMATOLOGY CENTER
Entity type:Organization
Organization Name:UPLAND RHEUMATOLOGY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SADEGHI-NAJAFABADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-932-1122
Mailing Address - Street 1:14535 GREENLEAF ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3770
Mailing Address - Country:US
Mailing Address - Phone:909-932-1122
Mailing Address - Fax:909-932-9292
Practice Address - Street 1:886 W FOOTHILL BLVD STE E
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3780
Practice Address - Country:US
Practice Address - Phone:909-932-1122
Practice Address - Fax:909-932-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty