Charles Enzio Pinkston, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA14875 Issued in CA

Practice address

1532 San Bernardino Ave
Suite Ca2
Pomona, CA 91767-3559

Phone

(909) 624-0392

Fax

(909) 624-0984

NPI assigned

Jan 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063568905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3685",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907033685",
            "telephone_number": "562-500-4644",
            "fax_number": "626-350-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 SAN BERNARDINO AVE",
            "address_2": "SUITE CA2",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917673559",
            "telephone_number": "909-624-0392",
            "fax_number": "909-624-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKSTON",
        "first_name": "CHARLES",
        "middle_name": "ENZIO",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA14875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecilia Dominguez Pimentel
• Elmer B Pineda, M.D.
• Megan Marie Pineda
• Siobhan Pineda
• Christine Pinedo, OTR/L
• Julia Taylor Pinsak
• Edgar Pintor
• Melika Pirodan
• Timothy Jacob Pisarski
• Planned Parenthood Los Angeles Pomona Center

• Physician Assistant in Pomona, CA
• Providers in Pomona, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.