Healthcare Provider Details

I. General information

NPI: 1174106231
Provider Name (Legal Business Name): UPLAND RHEUMATOLOGY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2021
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

886 W FOOTHILL BLVD STE E
UPLAND CA
91786-3780
US

IV. Provider business mailing address

14535 GREENLEAF ST
SHERMAN OAKS CA
91403-3770
US

V. Phone/Fax

Practice location:
  • Phone: 909-932-1122
  • Fax: 909-932-9292
Mailing address:
  • Phone: 909-932-1122
  • Fax: 909-932-9292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: EBRAHIM SADEGHI-NAJAFABADI
Title or Position: OWNER
Credential: MD
Phone: 909-932-1122