Individual provider Active NPI

Catherine Joy Cabugao

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1063091098
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
95017063 Issued in CA
Practice address
10841 White Oak Ave Ste 107
Rancho Cucamonga, CA 91730-3817
Phone
(909) 466-8888
NPI assigned
Apr 6, 2021
Last updated
Apr 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 95017063 CA Primary

Addresses

Primary practice location

10841 White Oak Ave Ste 107
Rancho Cucamonga, CA 91730-3817

Mailing address

10841 White Oak Ave Ste 107
Rancho Cucamonga, CA 91730-3817
Phone (909) 466-8888

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211026002611 CA Practitioner - Nurse Practitioner 4587052493 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1555 S Garey Ave
Pomona, CA 91766-5222
Phone (626) 919-4333

420 S Glendora Ave
West Covina, CA 91790-3001
Phone 6269194333259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Community Health Center, Inc. CurrentSince Oct 12, 2021 Accepting new patients
East Valley Community Health Center, Inc. CurrentSince Oct 12, 2021 Accepting new patients

Locations

1555 S Garey Ave
Pomona, CA 91766
Phone (909) 620-8088

420 S Glendora Ave
West Covina, CA 91790
Phone (626) 919-5724

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, 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": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617667200000",
    "number": "1063091098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10841 WHITE OAK AVE STE 107",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303817",
            "telephone_number": "909-466-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10841 WHITE OAK AVE STE 107",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303817",
            "telephone_number": "909-466-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABUGAO",
        "first_name": "CATHERINE JOY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-06",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "95017063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.