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PARKSIDE MEDICAL GROUP INC
NPI 1891935862
Psychiatry & Neurology - Neurology in Upland, CA

Active since March 03, 2009CLIA 05D1099304 · Waiver
1310 SAN BERNARDINO ROAD, SUITE 102, UPLAND, CA 91786(909) 608-2008(909) 608-7705 Get Directions Write a Review

NPPES record last updated: June 18, 2015. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Parkside Medical Group Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARKSIDE MEDICAL GROUP INC (NPI 1891935862) is a healthcare organization registered as a neurology in Upland, California and active in the NPI registry since March 2009. The organization holds a CLIA Waiver certificate valid through May 10, 2027 and lists Mohsen Ibrahim Ali, Owner, as its authorized official.

NPPES Registry Identity

NPI1891935862
Entity TypeOrganization
Primary Taxonomy2084N0400X
Legal Business NamePARKSIDE MEDICAL GROUP INC
Location Address1310 SAN BERNARDINO ROAD, SUITE 102Upland, CA 91786-4985
Mailing Address1310 San Bernardino Road, Suite 102Upland, CA 91786-4985 · (909) 608-2008 · Fax (909) 608-7705
Phone(909) 608-2008
Fax(909) 608-7705
Organization SubpartNo
Authorized OfficialMohsen Ibrahim AliOwner · (909) 608-2008
Enumeration DateMarch 3, 2009
Last NPPES UpdateJune 18, 2015
✔ NPI 1891935862 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · NeurologyAllopathic & Osteopathic Physicians
Taxonomy Code2084N0400X
License✔ Licensed in CA · A33406
Definition
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Also ListedInternal MedicineTaxonomy 207R00000X · License A101427 (CA)
1310 SAN BERNARDINO ROAD, Upland, CA 91786
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Parkside Medical Group Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Parkside Medical Group Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

William Baek, M.D..
Neurology
NPI 1326095977
630 N 13TH AVE SUITE B
Upland, CA 91786
(909) 982-2719
✔ PECOSSame address
Mohsen Ali, MD
Neurology
NPI 1750359071
1330 W COVINA BLVD SUITE 103
San Dimas, CA 91773
(909) 592-2145
✔ PECOS✔ Accepts Medicare11 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1099304

Parkside Medical Group · Upland, CA
Active · expires May 10, 2027
CLIA Number05D1099304
Laboratory TypePhysician Office
Certificate Effective DateMay 11, 2025
Certificate Expiration DateMay 10, 2027
Laboratory DirectorMohsen I. Ali, MD
Laboratory Phone(909) 608-2008
Laboratory LocationParkside Medical Group1310 San Bernardino Rd Ste 102, Upland, CA 91786
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Parkside Medical Group Inc's NPI number?

The NPI number for Parkside Medical Group Inc is 1891935862. It was assigned to this organization in the NPPES registry on March 3, 2009.

Where is Parkside Medical Group Inc located?

Parkside Medical Group Inc is located at 1310 San Bernardino Road Suite 102, Upland, CA 91786. The listed phone number is (909) 608-2008.

What is Parkside Medical Group Inc's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Neurology, with taxonomy code 2084N0400X.

Is Parkside Medical Group Inc enrolled in Medicare?

Yes. Parkside Medical Group Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Parkside Medical Group Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Neurology, reassign their Medicare billing to Parkside Medical Group Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Parkside Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1099304) is associated with this NPI, valid through May 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Parkside Medical Group Inc was last updated on June 18, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.