| Intellicare Medical | |
|
4500 Brockton Ave Ste 305 Riverside CA 92501-4027 | |
| (206) 445-9978 | |
| Not Available |
| Full Name | Intellicare Medical |
|---|---|
| Speciality | Internal Medicine |
| Location | 4500 Brockton Ave Ste 305, Riverside, California |
| Authorized Official Name and Position | Sivaraman K Gounder (PRESIDENT) |
| Authorized Official Contact | 7027622485 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intellicare Medical 32605 Temecula Pkwy Ste 205 Temecula CA 92592-6839 Ph: (206) 445-9978 | Intellicare Medical 4500 Brockton Ave Ste 305 Riverside CA 92501-4027 Ph: (206) 445-9978 |
| NPI Number | 1467024331 |
|---|---|
| Provider Enumeration Date | 07/12/2021 |
| Last Update Date | 03/12/2024 |
| Medicare PECOS PAC ID | 9335543974 |
|---|---|
| Medicare Enrollment ID | O20210804002898 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467024331 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Alireza Abidi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215919477 PECOS PAC ID: 5698704344 Enrollment ID: I20050811001138 |
| Provider Name | Samia Faiz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508961491 PECOS PAC ID: 9133229040 Enrollment ID: I20070706000401 |
| Provider Name | Ahmed M Mahmoud |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114940038 PECOS PAC ID: 4981777315 Enrollment ID: I20080718000195 |
| Provider Name | Gregory H Shimizu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154492130 PECOS PAC ID: 5395806038 Enrollment ID: I20081212000392 |
| Provider Name | Hoveda S Mufti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598871493 PECOS PAC ID: 0547322463 Enrollment ID: I20081230000453 |
| Provider Name | Mohammad S Kharazmi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033121272 PECOS PAC ID: 8022911841 Enrollment ID: I20090618000155 |
| Provider Name | Remus I Popa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265419519 PECOS PAC ID: 3577508597 Enrollment ID: I20090806000431 |
| Provider Name | Alina S Popa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003893348 PECOS PAC ID: 4981648839 Enrollment ID: I20090807000078 |
| Provider Name | Sivaraman K Gounder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740436237 PECOS PAC ID: 8426196825 Enrollment ID: I20110322000719 |
| Provider Name | Scott M Kubomoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073744546 PECOS PAC ID: 1951564236 Enrollment ID: I20120524000174 |
| Provider Name | Sahar Eivaz Mohammadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336560044 PECOS PAC ID: 5193032027 Enrollment ID: I20150909002985 |
| Provider Name | Christine Mikhail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538521067 PECOS PAC ID: 7810280963 Enrollment ID: I20200304002810 |
| Provider Name | Andrew Hwang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114458809 PECOS PAC ID: 0749605863 Enrollment ID: I20200806002934 |
| Provider Name | Walter George Lapinskas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598426389 PECOS PAC ID: 0143608497 Enrollment ID: I20220527001720 |
| Provider Name | Anam Azhar Goraya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174082432 PECOS PAC ID: 1557744422 Enrollment ID: I20220810003263 |
| Provider Name | Qais Ayouby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154884351 PECOS PAC ID: 9931582608 Enrollment ID: I20220812000382 |
| Provider Name | Manvir Singh Wadhwa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154881365 PECOS PAC ID: 5395120588 Enrollment ID: I20220926000214 |
| Provider Name | Omar Nagy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285194092 PECOS PAC ID: 1456754308 Enrollment ID: I20221006002262 |
| Provider Name | Joseph Alukal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801270699 PECOS PAC ID: 3678863107 Enrollment ID: I20221110002777 |
| Provider Name | Sophia Ho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790245256 PECOS PAC ID: 6406225150 Enrollment ID: I20221220000842 |
| Provider Name | Julie Farida Ayouby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093223042 PECOS PAC ID: 3476910027 Enrollment ID: I20230613001678 |
| Provider Name | Syed J Naqvi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649739806 PECOS PAC ID: 3072854298 Enrollment ID: I20230731003473 |
| Provider Name | Waqqas Shahid Mirza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407485295 PECOS PAC ID: 1951757327 Enrollment ID: I20231023000737 |
| Provider Name | Solomon Joshua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922502053 PECOS PAC ID: 6608131230 Enrollment ID: I20240113000263 |
| Provider Name | Jiraphat Sumner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366229189 PECOS PAC ID: 8022462803 Enrollment ID: I20240119001267 |
| Provider Name | Tamara Lynne Bautista Aqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992333447 PECOS PAC ID: 9032562954 Enrollment ID: I20240126003455 |
| Provider Name | Ruth Ramirez Cose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710766704 PECOS PAC ID: 0648619049 Enrollment ID: I20240418001054 |
| Provider Name | Osaigiakpe Np Ugheighele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770268740 PECOS PAC ID: 9032559463 Enrollment ID: I20240501003387 |
| Provider Name | Rachel Junhn Roan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003496894 PECOS PAC ID: 7810339611 Enrollment ID: I20240524001328 |
| Provider Name | Smita Lamba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902669377 PECOS PAC ID: 8224571617 Enrollment ID: I20240613001455 |
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