Provider Demographics
NPI:1891488037
Name:RIZVI, FATIMA S (RPA)
Entity Type:Individual
Prefix:
First Name:FATIMA
Middle Name:S
Last Name:RIZVI
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6972 FRASER FIR DR
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-1462
Mailing Address - Country:US
Mailing Address - Phone:909-682-5108
Mailing Address - Fax:
Practice Address - Street 1:8283 GROVE AVE STE 101
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3138
Practice Address - Country:US
Practice Address - Phone:909-483-1296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20CA5161243U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant