NPIMap

Organization Active NPI

Cal Poly University

  • Health Service Clinic/Center
  • Pomona, CA
National Provider Identifier
1033410113
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
261QOOOX Issued in CA
Legal business name
CAL POLY UNIVERSITY
Practice address
3801 W Temple Ave
#46
Pomona, CA 91768-2557
Phone
(909) 869-4222
Fax
(909) 869-4561
NPI assigned
Nov 5, 2010
Organization subpart
Yes
Parent organization
STUDENT HEALTH SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Ms. Kay Vierra
Title
Director
Phone
(909) 869-2760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 261QOOOX CA Primary

Addresses

Primary practice location

3801 W Temple Ave
#46
Pomona, CA 91768-2557

Mailing address

3801 W Temple Ave
#46
Pomona, CA 91768-2557
Phone (909) 869-4222

National Provider Directory

National Provider Directory
Part of
Cal Poly University

Locations

3801 W Temple Ave
#46
Pomona, CA 91768
Phone (909) 869-2748

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1033410113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W TEMPLE AVE",
            "address_2": "#46",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917682557",
            "telephone_number": "909-869-4222",
            "fax_number": "909-869-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 W TEMPLE AVE",
            "address_2": "#46",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917682557",
            "telephone_number": "909-869-4222",
            "fax_number": "909-869-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAL POLY UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STUDENT HEALTH SERVICES",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "VIERRA",
        "authorized_official_first_name": "KAY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "909-869-2760",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "261QOOOX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; 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.