Individual provider Active NPI

David J Underwood, M.D

  • Diagnostic Radiology Physician
  • Covina, CA
National Provider Identifier
1023080686
Registry record updated Oct 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G75458 Issued in CA
Practice address
414 E San Bernardino Rd
Covina, CA 91723-1704
Phone
(626) 915-5181
Fax
(626) 915-2313
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G75458 CA Primary

Addresses

Primary practice location

414 E San Bernardino Rd
Covina, CA 91723-1704

Mailing address

PO Box 5010
Glendora, CA 91740-0735
Phone (626) 915-5181

Other identifiers 1

IdentifierTypeStateIssuer
00G754580MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031114000675 CA Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 6800700725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Southern California Keck School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1520

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G75458CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arrowhead Radiology Medical Group Inc Diagnostic Radiology CurrentSince Dec 21, 2022 Accepting new patients
Glendora Radiological Assoc Inc Diagnostic Radiology CurrentSince Jul 1, 1997 Accepting new patients
Glendora Radiological Associates Inc Past Accepting new patients
Emanate Health Foothill Presbyterian Hospital Past Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

414 E San Bernardino Rd
Covina, CA 91723
Phone (626) 367-3206

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

Interoperability endpoints

  • Direct secure messaging: dunderwood262802@direct.llu.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224547200000",
    "number": "1023080686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917400735",
            "telephone_number": "626-915-5181",
            "fax_number": "626-331-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E SAN BERNARDINO RD",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231704",
            "telephone_number": "626-915-5181",
            "fax_number": "626-915-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G75458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G754580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.