J Kagwa-Nyanzi Pediatrics Clinic Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A45809 Issued in CA

Legal business name

J KAGWA-NYANZI PEDIATRICS CLINIC INC

Practice address

117 W Willow St Ste B
Pomona, CA 91768-1829

Phone

(909) 865-5519

NPI assigned

Jun 29, 2009

Organization subpart

No

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

Authorized official

Name

Juanita Kagwa, MD

Title

Ceo

Phone

(909) 865-5519

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1246233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246233600000",
    "number": "1073741039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W WILLOW ST STE B",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681829",
            "telephone_number": "909-865-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W WILLOW ST STE B",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917681829",
            "telephone_number": "909-865-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J KAGWA-NYANZI PEDIATRICS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-29",
        "last_updated": "2009-06-29",
        "status": "A",
        "authorized_official_last_name": "KAGWA",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-865-5519",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A45809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A458090",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jakia Islam
• Tasneem Islam
• Abigail Issaian
• Kristina Ittner
• Michelle Tiffany Iwaki
• Ja Medical Supplies.
• Duaa Jaafar, PA
• Yusuf Jabbar
• Edward Winston Jackson IV
• Evanne Bree Jackson

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; 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.