Healthcare Provider Details

I. General information

NPI: 1487903258
Provider Name (Legal Business Name): PARAMOUNT MEDICAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 KENNEDY STREET
RIALTO CA
92376
US

IV. Provider business mailing address

530 KENNEDY STREET
RIALTO CA
92376
US

V. Phone/Fax

Practice location:
  • Phone: 951-235-1030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA105268
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberA105268
License Number StateCA

VIII. Authorized Official

Name: DR. RIZWAN BADAR
Title or Position: CEO
Credential: M.D.
Phone: 951-235-1030