Individual provider Active NPI

Donald Wayne Kluge Jr.

  • Specialist
  • Loma Linda, CA
National Provider Identifier
1003942202
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
11306 Mountain View Ave
Ste B
Loma Linda, CA 92354-3832
Phone
(909) 478-9081
Fax
(909) 478-9084
NPI assigned
Feb 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

11306 Mountain View Ave
Ste B
Loma Linda, CA 92354-3832

Mailing address

11306 Mountain View Ave
Ste B
Loma Linda, CA 92354-3832
Phone (909) 478-9081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Image Prosthetics Incorporated Current Accepting new patients
Donald Wayne Kluge Jr Current Accepting new patients

Locations

11306 Mountain View Ave
Ste B
Loma Linda, CA 92354
Phone (909) 478-9081

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1003942202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11306 MOUNTAIN VIEW AVE",
            "address_2": "STE B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543832",
            "telephone_number": "909-478-9081",
            "fax_number": "909-478-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11306 MOUNTAIN VIEW AVE",
            "address_2": "STE B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543832",
            "telephone_number": "909-478-9081",
            "fax_number": "909-478-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUGE",
        "first_name": "DONALD",
        "middle_name": "WAYNE",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-24",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.