Individual provider Active NPI

Brent Pino

  • Family Medicine Physician
  • Colton, CA
National Provider Identifier
1063080943
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A22506 Issued in CA
Practice address
789 E Cooley Dr
Colton, CA 92324-4007
Phone
(833) 574-2273
NPI assigned
Jun 16, 2021
Last updated
Jan 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A22506 CA Primary

Addresses

Primary practice location

789 E Cooley Dr
Colton, CA 92324-4007

Mailing address

789 E Cooley Dr
Colton, CA 92324-4007
Phone (833) 574-2273

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
I20240821001878 CA Practitioner - Family Practice 9032657069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

789 E Cooley Dr
Colton, CA 92324-4007
Phone (888) 750-0036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A22506CAMDFamily Medicine Physician
22506CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 4, 2026 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 4, 2026 Accepting new patients
Family Care Specialists Medical Corporation Family Medicine Past Accepting new patients

Locations

789 E Cooley Dr
Colton, CA 92324
Phone (909) 370-6001

9961 Sierra Ave
Fontana, CA 92335
Phone (909) 427-3910

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1063080943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "789 E COOLEY DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244007",
            "telephone_number": "833-574-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 E COOLEY DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923244007",
            "telephone_number": "833-574-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINO",
        "first_name": "BRENT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-16",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A22506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.