| Anousheh Ashouri Inc | |
|
9440 Citrus Ave Fontana CA 92335-5512 | |
| (909) 823-3481 | |
| (909) 363-8629 |
| Full Name | Anousheh Ashouri Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9440 Citrus Ave, Fontana, California |
| Authorized Official Name and Position | Anousheh Ashouri (PRESIDENT) |
| Authorized Official Contact | 6304424206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anousheh Ashouri Inc 6926 Brockton Ave Ste 8 Riverside CA 92506-3804 Ph: (877) 414-7739 | Anousheh Ashouri Inc 9440 Citrus Ave Fontana CA 92335-5512 Ph: (909) 823-3481 |
| NPI Number | 1093174260 |
|---|---|
| Provider Enumeration Date | 02/16/2016 |
| Last Update Date | 11/16/2021 |
| Medicare PECOS PAC ID | 5496052516 |
|---|---|
| Medicare Enrollment ID | O20160404002059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093174260 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A113709 (California) | Primary |
| Provider Name | Anousheh N Ashouri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336305036 PECOS PAC ID: 3274769898 Enrollment ID: I20131203001714 |
| Provider Name | Erickson C Bautista |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285024083 PECOS PAC ID: 4385955046 Enrollment ID: I20150622001580 |
| Provider Name | Tracy M Bronson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972080455 PECOS PAC ID: 8729321765 Enrollment ID: I20190515001633 |
| Provider Name | Carlo Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891393732 PECOS PAC ID: 9133519333 Enrollment ID: I20211202000618 |
| Provider Name | Alexandra Reyes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396343224 PECOS PAC ID: 0547650699 Enrollment ID: I20211203000001 |
| Provider Name | Clarize Joie Amar Rafols-jarabe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558985952 PECOS PAC ID: 4486041373 Enrollment ID: I20220422002370 |
| Provider Name | Su Jung Joung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740944909 PECOS PAC ID: 3779965124 Enrollment ID: I20220801002547 |
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